In the belief that marginal ulcer that develops after subtotal gastrectomy is a distinct clinical entity, a study that evaluates the medical versus the surgical management of this disease was undertaken. Sixty-four patients with marginal ulcer were followed-up through a 10-year period. Most of the patients were managed on medical therapy alone. Seven of the 28 patients operated on represented medical failures. There was one surgical death and a recurrence of symptoms in nine of the 28 patients operated upon for marginal ulcer. In the medically treated group there was no mortality nor major morbidity such as gastrojejunocolic fistulas. We suggest that a reappraisal of the management of marginal ulcer after sub-total gastrectomy is in order.