Gastric precancerous lesions(GPL) represent the gradual transformation of chronic gastric mucosal inflammation into cancerous state,with the host's immune status and phenotypic shifts serving as pivotal regulatory mechanisms.This review systematically summarized the critical molecular events associated with the maturation,differentiation,inflammatory infiltration,and activation of various immune cells throughout the progression of gastric precancerous lesions.It further delved into the intercellular dialogue mechanisms within the immune microenvironment at the lesion site,encompassing interactions between diverse immune cells and between immune and non-immune cells.Drawing upon the traditional Chinese medical principle of "reinforcing the healthy qi to eliminate pathogenic factors",the paper explored the distinctive advantages and potential applications of traditional Chinese medicine in targeting immune cells for the intervention of gastric precancerous lesions.This approach offered novel perspectives and methods for immune intervention and pharmaceutical development in gastric precancerous lesions.