Primary gastric carcinoma accounts for only 0.05% of pediatric gastrointestinal malignancies. The pattern, presentation, and location of childhood gastric carcinoma are similar to those of adult gastric carcinoma. Diagnosis is based on a high index of suspicion in children who present with symptoms mimicking acid peptic disease. Delay in diagnosis is common and avoided by early upper gastrointestinal radiography and endoscopy with biopsy. Surgical therapy alone may prolong survival but thus far it has proven only palliative. The role of chemotherapy and radiation in gastric carcinoma is still not well defined, although some new studies in adults may support the use of etoposide, doxorubicin, and cisplatin as primary therapy or combined with surgery and radiation. Long-term survival in children is rare. We present the case of a 3-year survivor, free of disease, treated with resection and chemotherapy.