Primary small cell carcinoma of the stomach is an extremely rare tumor with only nine previously reported cases in the literature. Clinical behavior and prognosis are similar to small cell carcinomas of pulmonary origin. An additional case of a BI-year-old man with a gastric small cell carcinoma confined to the stomach is reported. The patient presented with an upper gastrointestinal bleed. A five centimeter ulcerated mass in the antrum was seen endoscopically and biopsied. At surgery the tumor appeared to be confined to the stomach and a subtotal gastrectomy was performed. The patient remains disease-free at 22 months. A review of nine other cases of small cell carcinoma of gastric origin reveals that most behave like their counterparts in the lung with rapid dissemination and death. However, like this patient, the only survivors for greater than one year are those amenable to surgical resection, implying that surgery has a roll in localized disease.