Gastric perforation of newborn is a rare, serious, and life threatening problem. The pathogenesis of gastric perforation is less well understood, and ranges widely. That ischemia is responsible for intestinal perforation enhances the likelihood that a similar mechanism exists for gastric perforation. Twelve patients with neonatal gastric perforation who were treated upon at the Department of Pediatric Surgery, Hanyang University Hospital from 1987 to 2002 were reviewed. Eight patients were male and four female. The age of perforation was 1 day to 8 days of life. Ten patients undertook operation and 2 patients were treated conservatively. The perforation site was located at the anterior wall along the greater curvature of the stomach in 8 patients and along the lessor curvature of the stomach in 2. The precipitating factors were gastroschisis, premature baby on ventilator and mechanical intestinal obstruction each 2 cases, and cyanotic heart disease and indomethacine medication each one case. In 5 cases the cause of perforation was not identified. The mortality rate was 25%(3 of 12). Earlier recognition and treatment were throught to be crucial prognostic factors.