Diagnostic and prognostic significance of α-methylacyl-CoA racemase (AMACR) has been established in many human cancers. Its correlation with clinical and pathologic data in gastric cancer has not been fully elucidated and its impact on surveillance has not been studied thus far. We analyzed consecutive gastric cancer cases in terms of AMACR expression and clinical/pathologic characteristics and followed patients' postoperative history. AMACR was expressed in 94/164 gastric cancers (57.3%). We did not find correlation between AMACR expression and sex, age, location, histologic type, pTN staging, vascular and nerve sheaths invasion. Overall disease-free survival tended to be worse in AMACR-positive patients (P=0.062), and in adenocarcinoma subgroup, it was significantly shorter (P=0.021). AMACR expression might represent promising adverse prognostic factor in gastric cancer, particularly in adenocarcinoma histologic type.