Objective: To investigate the clinical efficacy of laparoscopy-assisted D2 radical distal gastrectomy and the intraoperative perigastric vascular anatomy. Methods: Forty-five patients with gastric cancer who underwent laparoscopy-assisted D2 radical distal gastrectomy between June 2011 and June 2013 were reviewed, and the clinical efficacy and intraoperative perigastric vascular anatomy were analyzed. Results: Laparoscopic procedure was successfully completed in 43 of the 45 patients. The average operative time was (178.75±44.32) min, intraoperative blood loss was (100±50) mL, number of dissected lymph nodes was 27.55±7.52, time to bowel function recovery and ambulation was (3.2±1.1) and (2.5±1.0) d, and length of postoperative hospital stay was (11.5±7.5) d, respectively. The incidence of postoperative complications was 9.3%. In regard to vascular anatomy of the stomach, the left gastrcepiploic vessels were mainly seen originating from the distal third of splenic artery that was located in the anterior pancreatic space of the superior border of pancreatic tail; the superior mesenteric vessels were mainly located in the retropancreatic space of the inferior border of pancreatic neck, anterior to the uncinate process of pancreas and the horizontal part of the duodenum; right gastroepiploic vessels were mainly found in stomach mesenteries inferior to gastric pylorus and anterior to pancreatic head, but presented many variations; the coeliac trunk and its branches were mainly located in retropancreatic space of the superior border of pancreatic body, and the gastropancreatic fold, splenopancreatic fold and hepatopancreatic fold were anatomic landmarks for locating the left gastric artery, splenic artery and common hepatic artery, respectively. Conclusion: Laparoscopic D2 radical gastrectomy for distal gastric cancer is safe and feasible, and the strong knowledge of anatomy and the location of the perigastric vessels is crucial for surgical success.