The clinicopathological features of 31 young patients with early gastric cancer, defined as under 40 years of age, were reviewed retrospectively from hospital records between 1969 and 1993. The results were compared with those for 549 patients 40 years of age or older. Early gastric cancer was found in 36.0% of the younger patients with gastric cancers and in 36.3% of the older patients with those. The gender ratio of m/f was 1.21 for the younger patients and 2.37 for the older patients. The macroscopic characteristics of early gastric cancer for the younger patients were superficial depressed lesions and a larger tumor size. The distinguished histologic features of early gastric cancer for the younger patients were a diffuse type of cancer and infiltrative tumor growth with a scirrhous stroma. More extensive lymph node dissection was performed on the younger patients than on the older patients. The younger patients had a prognosis similar to that of the older patients. We conclude that early gastric cancer in young patients possesses histological aggressiveness, but those patients rather show a similar survival to older patients.