BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) has been known as a method of local treatment for early gastric cancer (EGC) or gastric adenoma. It has been widely accepted as a useful method due to its minimal invasiveness, safety and satisfactory result. The purpose of this study was to identify the factors affecting the recurrence after EMR. METHODS: Three hundred twenty adenomas in 297 patients were treated by EMR from January, 1991 until July 2003. Among those, 197 lesions in 184 patients that could have been followed-up were analyzed retrospectively. RESULTS: The mean follow-up period was 15.0 (1~89) months. Of the 197 lesions, there were 35 recurrences (17.7%). The recurrence rate was higher in lesions associated with severe mucosal atrophy and intestinal metaplasia in surrounding mucosa (p=0.035). Other factors showed no statistically significant difference in recurrence rate. CONCLUSIONS: In this study, we concluded that the presence of intestinal metaplasia and severe atrophic background mucosa were related to the recurrence of gastric adenoma after EMR.