Of 1383 patients with carcinoma of the stomach seen during a 30 yr interval, 37 were 35 yr of age or younger. Fourteen of the patients were < 30 yr of age and the females predominated. While all young adults underwent roentgenologic examination of the upper gastrointestinal tract, only 12 had findings considered diagnostic for a malignant lesion of the stomach at the time of the initial study. Endoscopy with biopsy was done in 16 patients and confirmed the diagnosis of carcinoma in 13 patients. Carcinoma of the stomach was first diagnosed at laparotomy in 13 patients. Only 30 of 37 patients were considered operative candidates. Of the gastric resections done, 19 were curative and 2, palliative. Of the lesions, 76% were linitis plastica or poorly differentiated adenocarcinomas, and lymph node metastases were present in 31 patients. Prognosis was dismal. Thirty-one patients were dead within 2 yr of diagnosis and only 2 patients have survived 5 yr. In this series, carcinoma of the stomach in young people was particularly lethal. A high index of suggestive symptoms should prompt an early, aggressive roentgenologic and endoscopic evaluation of the upper gastrointestinal tract if any chance for an increase in cure rates is to be realized.