Background. Worldwide, gastric cancer is the fourth leading cause of diseases, and the second leading cause of cancer deaths. Aim. To analyze the differences between men and women in mortality rate of gastric cancer in Belgrade from 1990?2002. Methods. Mortality rates standardized directly to the ?World population?, and regression analysis were used. Results. In Belgrade population, 29.2% out the total number of deaths attributable to cancer were caused by gastric cancer. Gastric cancer was the second most common cause of death among digestive tract cancers. In women, in the period between 1990 and 1993, an average annual decline of mortality was 9.0% (95% confidence interval (CI) = 5.9?13.1), and between 1994 and 2002, an average annual increase was 10.3% (CI = 8.4?12.6). Mortality rate series of gastric cancer in men did not fit any of the usual trend functions. The male/female gastric cancer mortality ratio was 1.7 : 1. Mortality rates for gastric cancer rose with age in both sexes and they were highest in the age group of 70 and more years. From 1990?2002, in both sexes aged 70 years and more, mortality from gastric cancer rose by 67.2% (CI = 58.0?76.4) in men and by 69.6% (CI = 60.6?78.6) in women. During the same period, the death rates in men decreased by 75.9 % (CI = 67.5?84.4) in the age group of 30?39 years, and by 48.1% (CI = 38.4?57.9) in women aged 50?59 years. In both sexes mortality rate series of all other age groups did not fit any of the usual trend functions. Conclusions. The increase in mortality rate of gastric in women over the past few years, showed the necessity of instituting primary and secondary preventive measures.