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Cardia cancer patients complicated with cirrhosis，hypersplenism，and portal hypertension constantly have contraindications to systemic drugs such as chemotherapy due to poor liver function，and surgery has become the preferred treatment for patients with such cardia tumors. Evaluation of surgical indications，optimization of surgical regimen，and perioperative management strategy are key factors for safe and successful implementation of these surgeries. Here，we reported a 65-year-old male patient undergoing laparoscopic splenectomy plus pericardiac vascularization combined with radical resection of cardiac carcinoma. Satisfactory clinical efficacy was obtained. He could eat semi-liquid diet at 2 weeks after surgery. During over 1-year follow-up，the patient was generally in good condition，could eat normal diet，and the white blood cell，red blood cell and platelet were restored normal. Liver function was normal，and no thrombosis was seen on portal ultrasound. This case prompts that for cardia cancer patients complicated with cirrhosis，hypersplenism，esophago-gas-tric fundal varices，esophageal stricture，this surgical regimen provides novel therapeutic ideas，which can be utilized as a safe and effective treatment option.