Approximately 10% to 30% of patients following gastrectomy develop recurrent or new-symptom complexes. This paper reports our experience with 50 patients after gastrectomy and stresses the importance of endoscopic evaluation in patients with mechanical-pathologic type disorders. Results of endoscopic examination were abnormal in 76%, whereas results of roentgenographic examination were abnormal in 38%. The results strongly suggest that patients with postgastrectomy complaints cannot be considered to have had a thorough work-up until endoscopic examination has been performed. Many times, patients with protracted complaints and normal x-ray films were found to have significant disease when endoscopy was performed.