Strictly speaking, the accuracy of pathology report of gastric ulcer is close to 100%, at least 98% or more. However, the accuracy rate does not always match exactly with the clinician’s gastric ulcer compliance rate, i.e., the accuracy rate is not 100% and depends mainly on the endoscopist’s means of operation. There is a difference between benign and malignant gastric ulcers. If it is a benign gastric ulcer, it is usually small, usually less than 2 cm, and the ulcer is relatively regular and flat, less likely to show very obvious necrosis, bleeding, etc. In the case of malignant ulcers, i.e. cancer, the ulcers are usually larger than 2cm and will form volcano-like manifestations of bleeding and necrosis. An endoscopist can generally determine whether an ulcer is benign or malignant when performing a gastroscopy. Certain tissues are taken by endoscopic forceps and sent to pathology department for examination. When the pathologist sees the tissues, he/she has to analyze the cell morphology and determine whether there is cancer. If the endoscopist takes cells that are not really cancerous, for example, the cells around the ulcer are only seen to have ulcers and inflammatory components, but not the cells that are really cancerous. The pathology department can’t see the real tumor cells in the gastroscopic pattern, and there is no way to issue an accurate cancer report at this time. However, if the endoscopist feels that it is likely to be cancer, a communication between the pathologist and the endoscopist is needed to clarify whether a second endoscopy is needed. Therefore, whether a gastric ulcer is benign or malignant requires close cooperation between the clinical and pathologist to be able to clarify.