Sections from 65 gastrectomy specimens obtained from operations performed for peptic ulcer or adenocarcinoma in Caucasian patients living in Hawaii were retrieved from the files of the Queen's Medical Center (n = 45) and the Kuakini Medical Center (n = 20). The sections were examined under high-power light microscopy for the presence of ciliated gastric epithelial cells in nondiseased areas of the gastric mucosa. Ciliated cells were found in 14 of the 65 specimens (21.5%) and were seen more often in elderly patients. The percentage of specimens with ciliated cells at the Kuakini Hospital was 35, which was very similar to the percentage found in a previous survey (40.5) in Japanese patients at the same hospital or in Japanese living in Japan (35%). In previous studies we found that ciliated gastric cells are rarely present in indigenous populations in Scandinavia, the U.S. mainland, Mexico, and Spain. Thus, our results seem to be a further indication that local environmental factors may trigger histological changes in the gastric mucosa and that those changes may be unrelated to the ethnic origin of the patient.