In recent years, there were more and more Siewert type Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction (AEG) diagnosed and treated at early stage, and proximal gastrectomy is an optional excision range recommended by various guidelines. But esophagogastrostomy used in early reconstruction causes quite higher incidence of reflux esophagitis (RE), which seriously affect the quality of life in these patients. Therefore, multiple procedures were derived to solve this problem. However, all these procedures have their own advantages and disadvantages, and there is still controversies about which one is the best. In this paper, we reviewed the historical evolution of digestive reconstruction after proximal gastrectomy and the existing controversies of various procedures.