Endoscopic submucosal dissection (ESD) is a standard treatment for early gastric cancer with a negligible risk of lymph node metastasis. Delayed gastric perforation after ESD is a rare complication. However, once this complication occurs, the symptoms are usually severe and most patients should be treated emergently. Until now, related researches have two main problems. For one thing, the sample size and source are limited; for another, the results of these researches varied widely. In order to prompt more scientists to pay attention to this complication, to do further researches on it and to acquire more reliable results, which can promote the better management, prevention and recovery of this complication, thus minimize the pain for the patients, we summarized some related researches and introduced the clinical characteristics such as reasons, clinical manifestations, management, prognosis and prevention of this complication.