BACKGROUND: The recent renewed and intense study of the pathological features of gastric carcinoma among gastroenterologists the world over has led to great improvements in the understanding of its biological behaviour and pathogenetic mechanisms. However, a review of the literature reveals a general dearth of information about gastric carcinoma and, especially, regarding the pathological features of gastric cancer, among Nigerian and African populations. With the hope that our findings would improve knowledge of the pathology of the disease among indigenous Africans and provide a foundation upon which further research work could be based, we carried out a detailed descriptive pathological characterization of gastric carcinomas received in the Department of Morbid Anatomy, Obafemi Awolowo University Teaching Hospital, Ile-Ife. METHODS: Gastric carcinoma cases received in our department over a ten-year period were classified grossly and microscopically according to Borrmann’s, Lauren’s, WHO and Broeder’s schemes respectively. The patterns of metastasis as well as other associated microscopic findings were reviewed. The data obtained was then analyzed using simple statistical methods. RESULTS: Gastric carcinoma was found in 53 (54.6%) males and 44 (45.4%) females with ages ranging between 25 years to 85 years. . The mean age at first clinical contact was 52.8 years while the peak age of occurrence was in the 6th decade of life. We found that 84 (86.7%) patients were 40 years and older at the time of diagnosis. Topographically, most cases (83.5%) of gastric carcinoma were 1 located in the antro-pyloric region. Nineteen (51.4%) and 15 (40.5%) of the cases reviewed were fungating tumours and excavated tumours respectively. Histological classification according to Lauren’s scheme showed that intestinal-type gastric carcinomas accounted for 86 (88.7%) cases while 10 (10.3%) were diffuse-type carcinomas and only one (1.0%) had a mixed pattern. According to the WHO scheme, the tubular carcinoma constituted 67 (69.1%) cases. Mucinous carcinoma was only seen in patients 50 years and older. We also found that 40 (41.3%), 30 (30.9%) and 27 (27.8%) of the cases were respectively well, moderately and poorly differentiated. Forty-three (91.5%) cases were advanced carcinomas at diagnosis while 4 (8.5%) cases were superficial carcinomas. The study showed that 27 (73.0%) of the 37 cases reviewed showed evidence of metastatic spread, the perigastric lymph nodes constituting the largest number. We also found that of the 79 cases which showed histological evidence of chronic gastritis, 43 (54.4%) were associated with H. pylori infection while 17 (21.5%) had gastric glandular atrophy. Atrophic changes were only seen in patients older than 40 years. Thirty- seven (46.8%) also showed histological evidence of intestinal metaplasia. CONCLUSSIONS: From this study the emerging picture of gastric carcinoma among Nigerians is that it is predominantly a disease of middle and late adult life that presents most commonly in the antro-pyloric region of the stomach as fungating or excavated and advanced, intestinal-type tumours that are well to moderately differentiated with peri-gastric lymph node metastasis. Its aetiology is to be putatively strongly linked with H. pylori induced chronic gastritis owing to its topography, predominant microscopic pattern and statistically significant association with chronic antral gastritis, gastric mucosal atrophy and intestinal metaplasia.