Background: Radical gastrectomy is the main modality of treatment for gastric cancer in Hong Kong. Metabolic bone disorder is a complication of gastrectomy, with reported prevalence varies from 10 to 40%. We aim to measure the prevalence of metabolic bone disease after radical gastrectomy in our locality. Methods: Patients who had radical gastrectomy performed for gastric tumor more than 3 years ago and now on remission of the disease were invited for the study. Serum and urine markers of bone metabolism were measured. Bone density of lumbar spine (from L2 to L4) and hip were measured with dual-energy x-ray absorptiometry. The prevalence of biochemical abnormalities and bone mineral loss in terms of osteropenia and osteoporosis were determined. Results: 68 patients entered into the study, with mean age of 60 (SD=10.9) years. There were 27 female. Twenty-four patients underwent radical total gastrectomy while the rest had subtotal gastrectomy. All had gastrointestinal continuity restored by Roux-en-Y reconstruction. They were 6.9+/-3.5 years after the operation. Altered serum markers of bone metabolism were observed in 35 (51%) of them, with decreased 25-hydroxy-vitamin D in 5 patients (7%), increased serum phosphate in 6 (9%), elevated bone alkaline phosphate in 16 (24%) and parathyroid hormone raised in 14 patients (21%), Significant loss of bone mineral density occurred in 48 patients (71%), with osteoporosis (T score less than -2.5) in 13 patients and osteopenia (T score between -1 to -2.5) in 35. Prevalence of significant bone loss was higher in those with biochemical abnormalities than those without (80% vs. 56%, p=0.032). Conclusion: There is a high prevalence of metabolic bone disease in patients after gastrectomy for carcinoma of stomach, especially those with abnormal biochemical markers of bone mineral metabolism.