Objective To investigate the clinical epidemiological characteristics of gastric carcinoma detected by endoscopy in Gansu province. Methods Data of patients with gastric carcinoma, which was detected by endoscopy and confirmed pathologically from January 1977 to December 2006 in 163 hospitals of Gansu province, were reviewed. The endoscopic findings, clinical manifestations and epidemiological features were retrospectively analyzed. Results A total of 34,116 patients were diagnosed as gastric carcinoma with the overall screening rate as 5.30% , which was decreasing in the recent years. The rate of cardiac and noncardiac cancer was 18.5% and 81.5% , respectively, and the rate of cardiac cancer raised from 16. 1% to 20.0% in the last decade. The tumor was most likely detected in antrum （38. 63% ）. The male/female ratio of gastric cancer is 3. 56： 1. The screening rate of gastric carcinoma was the highest in Wuwei district （8.19%）. The poorly differentiated adenocarcinoma accounted for 49. 64% in all patients. Conclusion Gastric carcinoma occurs most frequently in Wuwei district of Gansu province and was mostly detected in gastric antrum. The most common pathological type is poorly differentiated adenocarcinoma. In the past three decades, the detection rate of gastric cancer is decreasing, so is that of cardiac cancer, and that of the early gastric cancer is relatively low.