Objective: To investigate the influences on quality of life and prognosis of patients with advanced proximal gastric cancer undergoing different surgical methods. Methods: Clinical data of 110 patients with proximal gastric cancer admitted during the past 4 years were retrospectively analyzed. Of the patients, 53 cases underwent proximal radical gastrectomy with distal gastric preservation plus double-tract reconstruction that included end-to-side esophagojejunal anastomosis, side-to-side anastomosis of remnant stomach and jejunum, and end-to-side jejunojejunal anastomosis (double-tract anastomosis group), and the other 57 patients underwent conventional total gastrectomy plus esophagojejunal Roux-en-Y anastomosis (Roux-en-Y anastomosis group). Results: The 1-, 3- and 5-year survival rate in double-tract anastomosis group was respectively 99.4%, 67.3%, and 15.7%, in Roux-en-Y anastomosis group was 98.6%, 65.7% and 17.2%, respectively, and the difference between the two groups was of no statistical significance (P>0.05). Double-tract anastomosis group showed better results than Roux-en-Y anastomosis group in terms of prevention of the dumping syndrome and reflux esophagitis (both P<0.05), while no difference was found between the two groups in other aspects such as postoperative obstruction, hemorrhage and infection (all P>0.05). At one year after surgery, the alterations of body weight, plasma total protein, albumin and hemoglobin in double-tract anastomosis group were significantly better than those in Roux-en-Y anastomosis group (all P<0.05). Conclusion: The procedure of distal gastric preservation and double-tract jejunal anastomosis to esophagas and remnant stomach meets operation standards, does not violate the principles of the treatment of proximal gastric cancer, and also improves the patients’ quality of life. So, it is a relatively ideal reconstruction method following radical gastrectomy for proximal gastric cancer.