To determine the long-term risk of gastric cancer in benign peptic-ulcer disease, we studied 338 residents of Olmsted County, Minnesota, who had surgical treatment for benign peptic-ulcer disease in the 25-year period 1935-1959 and had no evidence of gastric cancer for five years after that surgery. These patients were subsequently followed for over 5635 person-years of observation. The risk of development of a gastric cancer in this group was compared with that expected on the basis of gastric-cancer incidence rates for the local population. Carcinomas in the gastric remnant developed in only two of these patients, as compared with an expected 2.6 primary gastric carcinomas (relative risk, 0.8 [95 per cent confidence interval, 0.1 to 2.7]). We conclude that there is no indication for endoscopic surveillance in asymptomatic patients with previous gastric surgery for benign peptic-ulcer disease.