Abstract: Objective: To summarize the experience of early diagnosis and compositive treatment in elderly with gastrointestinal multiple primary carcinoma. Methods: We retrospectively analyzed 26 elderly patients with gastrointestinal double primary carcinomas. Results: The rate of early diagnosis was 62%（32/52） in the 26 cases with 52 foci,operation for 39 foci,endoscopic mucosal resection（EMR） for 9 foci.The total resection rate of operation and EMR was 92%. The 5-year survival rate was 61%. The operation was performed in 17 cases for the second tumor, median survival was 30.5 months,12 patients with early cancer,5 patients with advanced cancer. The median survival time was 60 months for the patients after EMR,no difference in survival between operatinon group and EMR group（P =0.729 39）. Conclusion: EMR and operation for gastrointestinal mucosal carcinoma have the same effect,EMR is especially suitable for elderly. Early diagnosis and treatment of multiple primary carcinoma can provide long-term survival.