The case reported was a 54-year-old woman with adenocarcinoma of the stomach who developed microangiopathic hemolytic anemia (MHA) and disseminated intravascular coagulation (DIC). Clinical and laboratory data pertaining to this patient are presented. The patient died of multiple organ failure on the 12th hospital day. Since 1962, a total of 96 cases of MHA occurring in patients with malignancy have been reported. About half of them occurred in patients with gastric carcinoma. The possible pathogenesis of MHA and disseminated intravascular coagulation in patients with gastric adenocarcinoma is discussed.