The cause of death in 26 of 220 cases of early gastric carcinoma was studied, particularly in relation to the mode of recurrence. Of the 26, 7 patients died of disease related causes and gross appearance revealed that 4 cases were IIa predominant, 2 were IIc (or +I), and 1 was IIc predominant. Histologic examination indicated that all 7 cases were differentiated-type adenocarcinomas. Two of 7 recurring carcinomas were due to residual carcinoma in the resected stumps and 5 patients had hematogenous metastases, particularly in the liver. Eighteen of the 26 patients died of other causes, in 1 case of unknown causes, and it is interesting that in 5 of the 18 cases, simultaneous or nonsimultaneous double carcinomas at sites other than the stomach were noted. In order to prevent recurrence in early gastric carcinoma, it is important that no carcinoma be left in the resected stump or remnant, and that the prophylaxis be achieved through the administration of adequate amounts of anticancer chemotherapy, in order to prevent hematogenous metastasis, particularly to the liver.