This review was carried out to provide an up-to-date perspective on gastric cancer clinicoepidemiologicalcharacteristics, to explain geographical differences, and to define public health priorities for prevention andearly detection programs in Iran. A comprehensive search was conducted using different search engines andover 147 Persian medical journals from 1966 to December 2008. Inclusion criteria were published studies ongastric cancer clinical and epidemiological data. Abstracts only were excluded. Twenty five studies and twonational cancer registry reports were also included. The average gastric cancer incidence rates were reported tobe 15.2 (8.1 to 49.1) and 6.7(4.9-25.4) per 100,000 in males and females, respectively, with a ratio of 2.3:1 (1.5 to2.7). More than two thirds of them were diagnosed in stage IV. Crude mortality rates were estimated at 15.5 and8.4 per 100,000 in males and females. The trend for gastric cancer cases was increase from 1969 to 2004; antraladenocarcinomawas shifted to cardia adenocarcinoma in this period. The gastric cancer epidemiological aspectshave changed during 4 decades; a Western pattern has been started in Iran where the incidence rate ofadenocarcinoma of the most proximal cardia region and adjacent gastro-oesophageal junction has increased.Developing a gastric cancer early detection program, investigating gastric cancer risk factors, preventing patientand system delays, and providing national guidelines for treatment and palliation are all recommended.