We compared Billroth I with Roux-en-Y methods after distal gastrectomy in the early postoperative course for one year. Twenty-nine patients undergoing distal gastrectomy for gastric carcinoma were divided into two groups. Fifteen patients were reconstructed by Billroth I method after gastrectomy, and 14 patients by Roux-en-Y. Questionnaires were sent to all patients to ask their body weights, amount of oral intake, and subjective symptoms at the times of six month and one year after the surgery. Endoscopic study of the gastric semnant was performed at the same times. Endoscopic findings were scored based on the severity of gastritis. Complications after the surgery were also checked. There were no significant differences between two groups in terms of body weight, amount of oral intake, and subjective symptoms. Endoscopic findings of Roux-en-Y group, however, were better than those of Billroth I group at the time of six months after the surgery (11.8±0.7 vs 9.6±0.5, p<0.05). It is concluded that Roux-en-Y reconstruction after distal gastrectomy was not inferior to Billroth I method in the postoperative course and gastrointestinal complaints, and showed a significantly less degree of gastritis on endoscopic findings.