To explore the correlation between traditional Chinese medicine(TCM)syndrome differentiation and gastroscopy image of chronic gastritis，to confirm the scientific nature of TCM macroscopic syndrome differentiation and treatment from a micro perspective and to improve the theoretical system of TCM syndrome differentiation，so as to provide more objective basis for clinical diagnosis and treatment of chronic gastritis.Methods:A total of 385 patients with chronic gastritis admitted to Fangshan District Hospital of Traditional Chinese Medicine from Jan.1st 2016 to Jan.1st 2019 were selected as the research objects.The general data of all patients were selected.The 4 diagnoses of TCM(sight，smell，question and cut)，gastroscopic manifestations were collected.The common TCM syndromes(liver-stomach qi stagnation，liver-stomach stagnation heat，spleen-stomach dampness-heat，spleen-stomach qi deficiency，spleen-stomach deficiency-cold，stomach yin deficiency，stomach collateral stasis)and gastroscopic images，the correlations of atrophy，erosion，bile reflux，mucosal color，mucosal cistern color，mucosal congestion and edema，mucosal vessel exposure，mucosal eminence，mucosal roughness and mucosal granular hyperplasia were observed and different syndrome types in the gastric mirror image manifestation ratio were compared.Results:Spleen-stomach deficiency-cold syndrome，spleen-stomach damp-heat syndrome and liver-stomach stagnation-heat syndrome were the most common，accounting for 40.52%，30.91%，12.21% of the total，significantly higher than other syndromes(P<0.05); the most common lesions were gastric antrum，accounting for 49.92%，significantly higher than other parts(P<0.05); spleen-stomach deficiency-cold syndrome was more common in 40-65 years old patients，manifested as atrophic gastritis，with white mucosa predominantly and clear mucosal pools predominantly.The spleen-stomach damp-heat syndrome was mostly in males aged 18-40，mainly in non-atrophic gastritis and mucosal erosion; the liver-stomach stagnation-heat syndrome was mostly in males，with no significant changes in gastroscopy，which was similar to the spleen-stomach damp-heat syndrome.Conclusion:There is a certain correlation between TCM syndromes and gastroscopic images of chronic gastritis，especially spleen-stomach deficiency cold syndrome and spleen-stomach dampness-heat syndrome.The gastroscopic images can be used as objective basis of TCM syndromes，and can guide clinical scientific research.