We evaluated the effects of ethanolic neem leaf extract on N-methyl-N’-nitro-N-nitrosoguanidine (MNNG)-induced gastric carcinogenesis in Wistar rats. The extent of lipid peroxidation and the status of the antioxidants superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), glutathione peroxidase (GPx), and glutathione-Stransferase (GST) in the stomach, liver and erythrocytes were used as biomarkers of chemoprevention. Animals were divided into four groups of six animals each. Rats in group 1 were given MNNG (150 mg/kg bw) by intragastric intubation three times with a gap of 2 weeks in between the treatments. Rats in group 2 administered MNNG as in group 1, in addition received intragastric intubation of ethanolic neem leaf extract (200 mg/kg bw) three times per week starting on the day following the first exposure to MNNG and continued until the end of the experimental period. Group 3 animals were given ethanolic neem leaf extract alone, while group 4 served as controls. All the animals were killed after an experimental period of 26 weeks. Diminished lipid peroxidation in the stomach tumour tissue was associated with enhanced antioxidant levels. In contrast to tumour tissue, enhanced lipid peroxidation with compromised antioxidant defences was found in the liver and erythrocytes of tumour bearing animals. Administration of ethanolic neem leaf extract significantly reduced the incidence of stomach tumours, modulated lipid peroxidation and enhanced antioxidant status in the stomach, liver and blood. From the results of our study, we suggest that ethanolic neem leaf extract may exert its chemopreventive effects by modulating lipid peroxidation and enhancing the antioxidant status in the stomach, liver and erythrocytes.