Objective: To assess the value of local resection in treatment of carcinoma of the ampulla of Vater. Methods: The clinical data of 63 patients with T1 or T2 ampullary carcinoma treated between the years of 1997 and 2005 were retrospectively analyzed. Of the patients, 21 cases underwent local resection (observational group), while 42 cases were subjected to pancreaticoduodenectomy (control group). The operative time, intraoperative blood loss, intraoperative blood transfusion, incidence of postoperative complications, and length of hospital stay as well as postoperative survival between the two groups were compared. Results: The clinicopathologic data of the two groups were comparable (all P>0.05). In observational group compared with control group, the average operative time, intraoperative blood loss, intraoperative blood transfusion, and incidence of postoperative complications were significantly reduced (all P<0.05), while the average length of hospital stay showed no statistical difference (P>0.05). There was no statistical difference between the two groups in postoperative survival (P=0.131). Conclusion: Local resection causes less trauma and has a lower incidence of postoperative complications than pancreaticoduodenectomy in treatment of T1 or T2 ampullary carcinoma, and with favorable postoperative survival.