Abstract： Objective To investigate the treatment of Fuwei decoction for the prevention of gastric precancerous lesions and to elucidate the possible mechanism and medical effect underlying the activity.Methods A total of 140 rats with gastric precancerous lesions were utilized through traditional Chinese medicine (CM) and Western medicine prevention and treatment,in order to observe the various clinical changes of gastric mucosal pathology and Caspase-3.Results The results showed that the incidence of atypical hyperplasia treated by TCM group was 50.0％ (6/12) and that by western medicine prevention group was 42.86％ (6/14),which was significantly lower than gastric mucosal rebuilding group [90.0％ (9/10)](H =16.40,H =16.86,p＜0.05).Compared with gastric mucosal rebuilding gap group 90.9 ％(10/11)(H =12.39,H =12.18,P ＜0.05),the incidence of atypical hyperplasia (A&H) underlying TCM group and western medicine prevention group were 42.9％(6/14)and 41.7％ (5/12),respectively,which much of them was further confirmed as mild and moderate A&H [45.45％ (6/11),36.36 ％(4/11)].Furthermore,also it was found that all the groups,turn out to express with obvious rate discrepancy underlying Caspase-3 as:(1) the rate of gastric mucosal rebuilding group was lower than regular comparison group (q =3.05,P ＜0.01); (2) the rate of TCM group & western medicine prevention group is much higher than gastric mucosal rebuilding group & regular comparison group (q =5.45,q =7.54,q =8.51,q =10.60,P ＜0.01); (3) the rate of TCM group & western medicine treatment group is also rather higher than gastric mucosal rebuilding gap group & regular comparison group (q =15.66,q =18.53,q =15.66,q =18.53,P ＜0.01).Conclusion The findings of the current study illustrate that the Fuwei decoction has a protective & preventive effect on gastric precancerous.which is against the atypical hyperplasia on gastric epithelial cells underlying Caspase-3.