Objective To summarize and analyze the treatment options and prognostic factors of gastric stump carcinoma （GSC）. Methods The clinical data of 114 patients with GSC treated in The Second Affiliated Hospital of Northern Sichuan Medical College and The General Hospital of Chinese People’s Liberation Army from Mar. 2000 to May.2008 were reviewed， and influencing factors of surgical resection and prognosis were analyzed. Results For all patients，the ratios of surgical resection and curative resection（R0 resection） were 57.0%（65/114） and 54.4% （62/114）， respec-tively. The ratios of total gastrectomy， distal gastrectomy， proximal gastrectomy， endoscopic mucosal resection （EMR），and endoscopic submucosal dissection （ESD） were 73.8%（48/65）， 16.9%（11/65）， 3.1%（2/65）， 4.6%（3/65）， and 1.5%（1/65）in resection cases， and were 75.8%（47/62）， 16.1%（10/62）， 3.2%（2/62）， 4.8%（3/62）， and 0 in R0 resection cases， respectively. Seventy-five patients were followed-up for 0.3-79 months （median 12 months）， the mediansurvival time was 19.5 months， and 1-， 3-， and 5-year overall survival rates were 61.8%， 42.3%， and 30.1%， respectively. The results of multivariate analysis showed that resection rate was higher in patients with initial distalgastrectomy （P=0.002）， kps score≥80 （P=0.016）,lower macroscopic type （P=0.013）， and cM0 （P=0.000）. R0 resection （P=0.000）， macroscopic type （P=0.005）， and cT stage （P=0.006） were the independent prognostic factors. There were both no significant difference on survival between the patients with previous benign disease and those with original malignant disease when analyzed with univariate or multivariate method （P＞0.05）. There were no significant difference on overall survival curve among patients treated with palliative resection， palliative chemotherapy， simple laparotomy， and best supportive care （P＞0.05）. Conclusions The treatment options and prognosis of GSC were not influenced by the primary benign diseases or malignant diseases， and R0 resection is the most important prognostic factor. Removal of total remnant stomach is the best surgical procedure for GSC， and palliative laparotomy should be avoided.