A 55-year-old man was seen at the hospital because of sever epigastric pain. There was a previous history of undergoint a subtotal gastrectomy for duodenal ulcer 20 years before admission and he had been having anastomotic ulcer for these 6 years. On admission, an abdominal X-ray examination revealed free air at the subphrenic area. From the clinical course and findings, we diagnosed the lesion as perforative peritonitis caused by anastomotic ulcer. Upon laparotomy, perforated anastomotic ulcer as well as a Borrmann type 2 tu-mor in the remnant stomach was seen and a total gastrectomy and lymph node dissection were performed. The tumor was histologically diagnosed as endocrine cell carcinoma (ECC) . The tumor cells were positive for the Grimelius stain, and showed immuno expressions for NSE. Chromogranin-A stain and serotonin stain. He has been doing well without any recurrence as of 2 years after the operation. ECC is a relatively rare disease. The prognosis of this disease is very poor because of its rapid growth, metastasis and invasion in an early stage. Forty-two ECCs of the stomach including four cases arising in the remnant stomach have been reported in the Japanese literature.