OBJECTIVE Thymidine Phosphorylase/ Platelet Derived-Endothelial Cell Growth Factor (TP/PD-ECGF) has an angiogenic and chemotherapeutic effects. The aim of this work was to evaluate TP/PD-ECGF expression in gastric adenocarcinoma and find its correlation with established clinicopathological parameters and patients' survival. METHODS Samples studied consisted of fifty-two gastric specimens (27 cases of chronic gastritis and 25 cases of malignant adenocarcinoma). Immunohistochemical staining for TP/PD-ECGF was done and the tumor was considered positive when more than 5% of cells showed positive staining. RESULTS TP/PD-ECGF expression was significantly higher in the malignant group when compared to the control group (p = 0.001). Tumor and stromal cell TP/PD-ECGF expression in the malignant group was significantly correlated with size of the tumor, mitotic count, stage grouping, depth of invasion, number of lymph nodes (LN) involved, perineural invasion, lymphoplasmacytic and tumor associated macrophages (TAMs) infiltration and vessel density (VD). Furthermore, stromal expression of TP/PD-ECGF was significantly correlated with postoperative chemotherapy and apoptotic count. Survival analysis revealed that proximal tumor, small size, early stage, negative LN metastasis, absence of perineural invasion, low VD and negative tumor and stromal TP/PD-ECGF expression correlated with better patients' survival. CONCLUSIONS TP/PD-ECGF might have an angiogenic function and role in tumor growth, invasion and metastasis. TP/PD-ECGF could enhance the effect of postoperative chemotherapy.