The relation of microbial flora in stomach contents and stomach wall was examined in paired specimens from 10 surgical patients and in specimens of wall from 10 additional patients. The flora of both contents and wall were similar. Paired specimens from five patients contained the same kinds of bacteria. Paired specimens from these patients were sterile. Contents from two patients contained bacteria, but the wall was sterile. Microorganisms isolated were streptococci, lactobacilli, bifidobacteria, bacteroides, staphylococci yeast, and coliforms. Bacterial counts ranged from 0 to 10(7.5) per ml or g in both contents and tissue. Survey of the literature shows that most specimens from patients with gastric ulcers or gastric malignancies are positive for bacteria, while only about 60% of specimens from patients with duodenal ulcers are positive.