Abstract: Objective: To investigate the etiological agent and the prognosis of the inflammation in the gastric cardia in the aged. Methods: The carditis was identified by endoscopic findings,all biopsy specimens of the cardia were obtained below the Z-line within 4cm of the proximal stomach. The carditis had histological evidence of the grade of inflammation,H. pylori infection,intestinal metaplasia according to the updated Sydney classification. Results: All of the 97 cases had lamina propria mucosa inflammation,68（70.1%）were mild-moderate and 29（29.9%）were severe inflammation. 39（40.2%） had mucosa erosion,33（34.0%）had intestinal metaplasia. 36（37.1%）had H. pylori in cardia and 65 （67.0%） in other parts of the stomach. Background data were collected on age,diagnosis,symptoms,75（77.3%）had atrophic gastritis,66（68.0%）had GERD,27 （27.8%） had polypus of cardia,7（7.2%）cardia erosion became adenocarcinoma. Conclusions: Our data support that gastroesophageal reflux is the major cause of carditis,H. pylori infection as also being the etiologic agent for this disease in the group of patients. It should be emphasized that persistent erosion may be the risk factor for cardia adenocarcinoma.