Abstract: Objective To investigate the correlation between endoscopic findings and pathologic features of gastric cardia ulcer. Methods A retrospective analysis of the endoscopic and pathology results of 308 cases diagnosed as gastric cardia ulcer from March 2011 to February 2016 in Chinese PLA General Hospital was performed. Results There were 264 males (85.7%) and 44 females(14.3%) in the sample, and 61.3% of them were older than 60 years old. Malignant ulcer accounted for 65.9% of all the cases. The percentage of cardiac adenocarcinoma was 85.5%. The rates of cardiac carcinoma in single ulcer, > 2.0 cm and coating dirty color of ulcer were 58%, 78%, 87.5% respectively. The consistence of endoscopic performance and pathological degree was 71.1%. Conclusion The canceration rate of cardia ulcer was high, and the endoscopic performance was not highly consistent with pathological degree.