15 patients urgently suspected of gastric cancer on account of clinical and x-ray findings were subjected to preoperative gastroscopy. In all cases, a malignant gastric tumour could be excluded via gastroscopy with biopsy. However, in one remarkable case the clinical and x-ray findings had been so typical of a malignant tumour, that surgery was performed despite negative gastroscopy and biopsy. No tumour was found. The x-ray findings were correlated with those of endoscopy. Three patients had hiatal hernia (in one case combined with varices of the fundus of the stomach) and in one case each large and irregular plication was normal in seven cases. The results are discussed on the basis of the findings and relevant literature. It is concluded from this study that routine preoperative gastroscopy with biopsy is mandatory in clinical and x-ray suspicion of gastric cancer, since it may result in avoidance of surgery in some patients.