Purpose: Exploring the Clinical Safety and Feasibility of 5G Remote Surgery Robot-Assisted Gastrectomy. Methods: A retrospective analysis was conducted on the clinical data of two patients who underwent 5G remote surgery robot-assisted gastrectomy at the General Surgery Clinical Center of Gansu Provincial Hospital from June to September 2024. One case involved a cross-provincial remote surgery between Gansu Provincial Hospital and Yangzhou University Affiliated Hospital, located over 1700 km apart, classified as the “long-distance patient.” The other case involved a remote surgery within the province, between Gansu Provincial Hospital and the Gansu Provincial Hospital (Lanzhou New District Branch), located 70 km apart, classified as the “short-distance patient.” General data, intraoperative conditions, network status, postoperative routine information, and postoperative follow-up data were recorded and analyzed for two patients. Result: Both patients successfully completed the surgery. The master-slave control duration for the long-distance surgery patient and the short-distance surgery patient were 259 min and 308 min, respectively; the total surgical durations were 285 min and 320 min, respectively. Neither patient experienced an intraoperative conversion to traditional surgery. The average total delay for the long-distance surgery patient was 99 ms, and for the short-distance surgery patient, it was 48 ms; the packet loss rates were 0.0188% and 0%, respectively, with no network jitter or interruptions observed. The long-distance surgery patient had a drainage tube retention time of 10 d, a postoperative hospital stay of 14 d. The short-distance surgery patient had a drainage tube retention time of 8 d, a postoperative hospital stay of 10 d. No postoperative complications occurred in either patient. Conclusion: This study suggests that 5G remote surgery is feasible and safe, but larger-scale research is needed. © The Author(s) 2025.