Malignant gastric ulcer refers to recurring intractable gastric ulcers, which indicates that gastric ulcers have a tendency to become worse and should be actively treated. Patients with malignant gastric ulcers need to seek timely medical treatment, which can be carried out through medication, and should undergo timely surgical treatment if the desired effect cannot be achieved by medication or if there is malignant transformation. Malignant gastric ulcer is usually treated with a combination of drugs, mainly including drugs to inhibit gastric acid secretion, drugs to protect the gastric mucosa, etc. The specific use of drugs and time should follow the doctor’s instructions. Drugs that inhibit gastric acid secretion include omeprazole, rabeprazole and other proton pump inhibitors, which can usually control the symptoms of gastric ulcer within 2-3 days, with good results. Drugs to protect the gastric mucosa include bismuth potassium citrate, bismuth pectin and other bismuth agents, but renal dysfunction is contraindicated; as well as aluminum hydroxide, sodium bicarbonate and other antacids, which can directly neutralize the gastric acid and reduce the stimulation of gastric acid on the mucosa. For cases where taking medications cannot cure gastric ulcers, such as massive or repeated bleeding, highly suspected malignant gastric ulcers, etc., it is recommended that surgical treatments be performed under the guidance of a doctor to remove the ulcerated area and prevent recurrence or malignant changes.