Forty-five cases of primary gastric carcinoma were investigated immunohistochemically for p53 protein accumulation and MDM2 protein overexpression. The results were correlated with pathological and clinical data. The incidence of p53 accumulation was 12 of 45 (26.7%) cases and that of MDM2 expression was 30 of 45 (66.7%). Eighteen of 45 (40%) cases showed MDM2 overexpression without p53 accumulation. All of the 12 p53-positive cases exhibited a co-expression of MDM2. Accumulation of p53 and MDM2 overexpression correlated with the grade of malignancy. MDM2 expression occurred more often in intestinal carcinomas than in the diffuse types. No correlation was found between p53 accumulation and the histopathology of gastric cancer. p53 accumulation and MDM2 overexpression did not correlate with tumor size, nodal status, presence of metastases, age or survival. p53 alteration, which seems to be a late step in gastric carcinogenesis, is a marker of higher grade tumors. MDM2 functions as a cofactor of p53 in late gastric carcinogenesis. An independent role of this oncoprotein in gastric carcinogenesis also seems possible. Neither p53 nor MDM2 is a useful prognostic indicator.