Background: There is an assertion that esophagogastroduodenoscopy (EGD) should be included in the routine diagnostic work-up of extra nodal marginal zone lymphoma (MZL) based on an observation that a significant proportion of patients presenting with nongastric MZL had gastric involvement as well. However, incidence of gastric involvement in nongastric MZL has not been investigated in Asia, where incidence of MZL is higher than Western countries. Aims: The present study was undertaken to assess the incidence of gastric involvement in nongastric marginal zone lymphoma. Methods: Between April 1993 and December 2010, 153 consecutive patients with nongastric MZL were treated in the Asan Medical Center, Seoul, Korea. We retrospectively analyzed the results of these patients. Results: We present our experience of 47 cases of EGD which comprised 30.7% of all 153 nongastric MZL patients. The median age at diagnosis was 51 years, and the overall male-to-female ratio was 0.72. One hundred patients (86.3%) initially presented with localized disease (defined by Ann Arbor stage I/II), 2 (1.3%), 15 (9.8%), 4 (2.6%) patients were stage IIIa, IVa, IVb, respectively. In 136 patients (88.9%), single site of extranodal involvement of lymphoma was identified. The most common primary site of nongastric MZL was ocular adnexa and orbit (48.4%), intestine (11.1%), lung (9.8%), nasal sinus (5.9%) in decreasing order of frequency. Of 153 nongastric MZL patients, 47 patients (30.7%) were underwent EGD for initial staging work-up, and no patient was found to have gastric involvement of lymphoma. The most common endoscopic and pathologic diagnosis of EGD was chronic superficial gastritis (16 patients, 34%) (Table 1). Summary: None of the 47 patients who had undergone EGD had gastric involvement of EGD. Our findings do not support routine EGD in patients with extranodal MZL. Table1. Endoscopic diagnosis whom underwent EGD for routine work-up of extra nodal MZL.