Frequency and characteristics of early gastric cancer (egc) were evaluated in a retrospective study of 511 surgical specimens of gastric carcinoma. We observed a total of 46 egc in 40 patients. The predominant macroscopic type was IIc, followed by I and III. On the basis of histological appearance, 25 egc were of intestinal type and 15 of diffuse type. Seventy-six per cent of egc were localized at the lesser curvature of the stomach and in particular at the pyloric antrum. Twenty-two egc were limited to the muscosal layer. no relationship was observed between macroscopic type or histological characters, and tumour staging. As Italy can be considered a high-risk country for gastric carcinoma and because this disease is in many respects similar to that observed in Japan, it seems possible to obtain a reduction of the death rate for gastric cancer by increasing, as in Japan, the number of cancers diagnosed in the early phase.