Objective To investigate the clinical features of early stage gastric mucosa-associated lymphoid tissue (MALT) lymphoma and the efficacy of eradication of Helicobacter pylori (Hp) and anti-tumor therapy. Methods Clinical data of 52 patients diagnosed as gastric MALT-lymphoma of stages Ⅰ/Ⅱ in our hospital from April 2003 to May 2013 were collected and retrospectively analyzed. Hp eradication was attempted in the patients with Hp infection. Patients with lymphoma persistence or progression following Hp treatments were given further anti-tumor treatments. Results Hp infection rate was 88.4% in the 52 patients with early stage gastric MALT. The efficiency of Hp eradication was 91.3%. For the 18 patients receiving anti-tumor treatments, the efficiency was 66.7%. The 5-year overall survival rate and progression free survival rate were 92.3% and 83.1%, respectively. Conclusion Hp eradication is an irrational and efficient approach in the treatment of early stage gastric MALT lymphoma. For the patients who fail to respond to Hp therapy, anti-tumor treatment is necessary for their long-term benefits.