To explore the causes of the threefold variation in mortality rate from gastric cancer in Japan, we studied the geographic correlations between food consumption and age-adjusted mortality rates in five regions, which covered the areas with the highest and lowest mortality rates in the country. Six hundred thirty-four men and wives of 373 of the men sampled from the general populations in these districts were interviewed about intake frequency of 38 food items. Age-adjusted mean frequencies of food intake differed markedly among the regions, in which 32 food items for men and 28 for women showed a significant difference (p < 0.05). Rank correlation coefficients between the average frequencies and the mortality rates with adjustment for sex and prevalence of current smokers were 0.49, 0.32, 0.36, -0.88, and -0.57 for rice, bean paste soup, pickled vegetables, green vegetables, and yellow vegetables, respectively. These results suggest that the regional differences in consumption of these foods may account partly for the geographic variation in gastric cancer mortality in Japan.