Abstract: Due to its unique anatomical location, there are many unresolved issues in the diagnosis and treatment of esophagogastric junction (EGJ) cancer, which is not only a hot topic of concern in various related disciplines, but also a controversial topic among scholars in both the East and the West academia. The 15^th International Gastric Cancer Congress in 2023 focuses on EGJ cancer, organi-zing consensus voting among experts from various disciplines on surgery, digestive endoscopy, and oncology issues before the conference. Multiple sub venues are also set up to discuss related issues. Meanwhile, Japanese scholars have proposed that the lymph node dissection process for EGJ cancer, modified based on the lymph node dissection therapeutic value index, is expected to be updated in the new version of the Japanese gastric cancer treatment guideline. The perioperative treatment of EGJ cancer highlights the differences in concepts and measures between the East and the West academia. Asian scholars focus on neoadjuvant chemotherapy based on DOS treatment plan, while European and American scholars hope to find the best perioperative treatment plan from the neoadjuvant chemoradiotherapy of CROSS research. However, the new adjuvant therapy regimen with the addition of immune checkpoint inhibitors has only established advantages in tumor regression and decline, and has not yet shown significant benefits in long‑term survival. It cannot be denied that the diagnosis and treatment of EGJ cancer are still constantly exploring and advancing. In the future, we look forward to more new evidence‑based medicine to provide ideas and expand our horizons for minimally invasive, precise, individualized, and comprehensive clinical diagnosis and treatment. Based on our understanding and insights into the differences and controversies between Eastern and Western scholars in the background, concepts, technologies, and treatment plans of EGJ cancer, the authors elaborate and analyze the hot issues of EGJ cancer diagnosis and treatment, combined with the latest content of the 2023 IGCC and other international conferences, in order to bring more thinking and analysis to colleagues and better guide clinical work.