Objective: To evaluate the safety and feasibility of splenic hilar lymph node dissection during modified hand-assisted laparoscopic radical total gastrectomy. Methods: The clinical data of 8 gastric cancer patients undergoing modified hand-assisted laparoscopic radical total gastrectomy and splenic hilar lymph node dissection from June 2012 to July 2013 were retrospectively analyzed. Results: Procedures were successfully completed in all the 8 patients without open conversion, and none of them underwent splenectomy for intraoperative splenic vascular or parenchymal injury. A total of 27 lymph nodes were dissected from the 8 patients, and 3 (11.1%) of the lymph nodes were found positive for cancer. The average time for splenic hilar lymph node dissection was 23 min, average intraoperative blood loss was 176 mL, and average length of postoperative hospital stay was 9.5 d. One patient developed pulmonary infection after operation. The average cumulative follow-up for all patients was 3.6 months, during which time, no tumor recurrence or death occurred, and the general condition of all of the patients was satisfactory. Conclusion: Splenic hilar lymph node dissection during modified hand-assisted laparoscopic radical total gastrectomy is safe and feasible; however, its long-term effectiveness must be further assessed.