Gastric xanthelasmas are macroscopically well demarcated yellow or yellow-white plaques, and microscopically composed of typical foamy macrophages. Of 3870 patients who underwent upper gastrointestinal panendoscopic examinations, 30 (0.8%) were found to have gastric xanthelasma. A moderate predominance of males over females (M:F = 3.3:1) was noted. The age ranged between 21 and 69 years (mean 46.7). Frequency peaked in those from 40 to 60 years of age (53.3%). Single lesions were found in 26 patients and multiple in 4, with diameters of 1-6 mm, nearly 66.7% of which were 2-3 mm. Gastric xanthelasmas are most frequently found in the antrum (67.8%), especially along the lesser curvature. Associated chronic gastritis in the xanthelasma surrounding mucosa was found in the 30 patients and intestinal metaplasia in 4 (13.3%). The cause of gastric xanthelasma is unknown, but chronic gastritis may be the most plausible etiologic factor.