The total number of elderly persons with gastric ulcers in Japan is increasing with an improvement in the average life expectancy. So far, gastric ulcer in elderly persons is considered proximal gastric ulcer due to corpus-predominant atrophic gastritis. However, the clinical features of the disease will change with a decrease in the number of persons with Helicobacter pylori infection. On the other hand, the numbers of persons with gastric ulcers associated with aging-related diseases and those with gastric ulcers induced by drugs such as nonsteroidal anti-inflammatory drugs and aspirin are increasing. Even recently, there have been no changes in the mortality of patients with severe gastric ulcers. Management based on pathological conditions of gastric ulcers in the elderly persons is required.