Borrmann type 4 gastric is a malignant disease that shows enlarged gastric folds, and this is easily mistaken as a mucosal flare or as inflammation because a third of these patients show normal mucosa without mucosal defects and the lesion diffusively infiltrates into the submucosal area. Endoscopic ultrasonography is an effective tool for making the differential diagnosis of gastric subepithelial lesion and hypertrophic gastric fold when endoscopy is not suitable to use. Eosinophilic gastritis is a benign lesion with enlarged gastric folds and it shows pathologic eosinophil infiltration in the walls of the stomach. We report here on a case that was suspected to be Borrmann type 4 advanced gastric cancer according to the endoscopic ultrasonography and this was confirmed by abdominal operation. Otherwise, this condition would have been mistaken for eosinophilic gastritis.