Background To investigate the value of anti-helicobacter pylori (Hp) antibody, serum carbohydrate antigen (CA)-724, CA19-9, and carcinoembryonic antigen (CEA) in the diagnosis and prognosis evaluation of young patients with early gastric cancer. Methods A total of 200 young patients with gastric cancer from April 2014 to December 2015 were enrolled. A total of 206 patients with gastritis and 204 healthy subjects were also selected. Gastric cancer patients were followed up for 3 years, and the number of recurrences, metastasis, and death was recorded. Results The positive rate of anti-Hp antibody, CA724, CA19-9, and CEA in young patients with early gastric cancer were significantly higher than those in gastritis and healthy subjects (P < .05), and was positively correlated with tumor stage, tumor size, and lymph node metastasis (P < .05). The predicting model was as follows: Logit (P) = 26.433-3.014(CA724)-3.908(CA19-9)-0.303(CEA)-2.208(anti-Hp antibody, Positive = 1; Negative = 0). This model had a high value in identifying young patients with early gastric cancer with AUC of 0.918, and the estimated probability was .806. Compared to patients with negative anti-Hp antibody and low serum levels of CA724, CA19-9, and CEA, the recurrence rate, metastasis rate, and mortality of patients with positive anti-Hp antibody, high serum levels of CA724, CA19-9, and CEA increased significantly (P < .05). Conclusion This study indicated that anti-Hp antibody combined with CA724, CA19-9, and CEA had important value in the identification of young patients with early gastric cancer and were of great value in evaluating the risk of postoperative recurrence, metastasis, and death.