PURPOSE: To evaluate the value of helical CT in patients with endoscopically and pathologically proven early gastric cancer. MATERIALS AND METHODS: Helical CT scans(5-mm section thickness, 5-mm/sec table speed) were obtained in 45 patients with pathologically proven early gastric cancer. CT findings were retrospectively reviewed by two independent radiologists without surgical or pathologic information. Detection rate, depth of invasion, and lymph node staging were evaluated. RESULTS: The overall detection rate was 52% ; there was no significant difference in the rates between observer A(55%) and B(49%). The detection rate was higher in the anterior bodywall(100%) and antrum(63%) than in the posterior body wall(42%) and antrum(53%). The detection rate of the depressed type(63%) was higher than that of the elevated type(38%). Submucosal stripe was seen in 45% of mucosallesions and in 32% of submucosal lesions, though the stripe was not a reliable indicator for depth of invasion.Lymph node metastasis was detected in only one of eight patients. None was found to have distant metastasis. CONCLUSION: Helical CT is of little help in the evaluation of endoscopically evident early gastric cancer and the routine use of helical CT is not recommended in early gastric cancer.