Aims: Renal transplantation has considered the treatment of choice for end-stage renal disease. However, renal transplantation increases the risk of cancers due to long-term immunosuppression. The types of post-transplantation malignancies may vary among different geographic regions and ethnic populations. Little is known about the characteristics of gastric adenocarcinoma after renal transplantation. This study was performed to find out the incidence and clinicopathological features of gastric adenocarcinoma after renal transplantation in an endemic area for gastric cancer. Methods: PubMed and Embase databases were searched, MeSH terms used were: “kidney transplantation”, “gastric cancer”, “gastric cancer sirolimus”, “gastric cancer everolimus”, “Helicobacter Pylori”. We limited our search to clinical trials, randomized controlled trials and reviews in the past 10 years. Abstracts of retrieved citations were reviewed and prioritized by relevance. Full articles were obtained and reference lists were reviewed for additional articles when appropriate. Results: In Colombia, gastric cancer (GC) is a disease of high prevalence and morbi-mortality; it is the second cause of death in men and the third in women. The most common type of GC is intestinal adenocarcinoma. In a non transplanted population “the doubling time” in an early stage of GC is of two years. Theoretically, if the GC is undetected in an endoscopy, a second exam practiced at two years could detect a tractable tumor. A transplanted patient who lives in an endemic area must undergo an endoscopic control once a year, since early detection of GC improves survival at five years (more tan 90%) and also can be removed endoscopically. In reference to immunosupresive therapy, mTOR inhibitor, (mammalian target of rapamycin) may convert invasive celular phenotypes to those non invasive, they may prevent tumoral development and methastasis, they also stop cellular cycle, lead to apoptosis and they are potentially effective against angiogenesis dependant tumors. However, it has been found that only 50% of GC presents mTOR activity, therefore they would only be effective for this population. Helicobater pylori is associated with increased risk for developing dysplasia and GA. That risk would be decreased with adequate treatment by abolishing the bacteria. This is especially true of young adults before histological pre-neoplasic changes like atrophy and intestinal neoplasy are present Conclusions: Renal transplant recipients are at increased risk of developing gastric adenocarcinoma, one of the most common malignancies in Colombia. With curative surgery, favorable prognosis can be anticipated, given the diagnosis has been made at an early stage. Annual endoscopic examination for early diagnosis is recommended during the follow-up period after renal transplantation in a gastric cancer endemic area. GC patients with mTOR activity should be changed to sirolimus or everolimus immunosupresive therapy. Patients with H Pylori must be properly treated.