Objective To investigate the effect of metastasis of group 10 splenic lymph node on the prognosis of patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy. Methods From Jan. 2010 to Jan. 2014, a total of 298 patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy in our hospital were taken as the research objects. All the patients were followed up for 3 years, and the 3-year survival rates were recorded according to their hospital review, outpatient review and telephone follow-up. Results Univariate analysis showed that preoperative CEA, preoperative CA72-4, tumor size, Borrmann type, depth of tumor invasion, lymph node metastasis staging, metastasis of group 10 lymph node and formation of gastric cancer nodules can affect the 3-year survival rates of patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy(P<0.05), multivariate analysis showed that the T4 depth of tumor invasion, the ⅢC stage in TNM classification of tumor, metastasis of group 10 lymph node and formation of gastric cancer nodules were independent risk factors affecting the prognosis of patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy(P<0.05). Conclusion T4 depth of tumor invasion, the ⅢC stage in TNM classification of tumor, metastasis of group 10 lymph node and formation of gastric cancer nodules are independent risk factors affecting the prognosis of patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy.