121 Background: Gastrectomy is a risk factor for low bone mass. We aimed to investigate the relative risk for osteoporosis in gastric cancer survivorship compared to general population. Methods: Using Korea National Health and Nutrition Examination Survey (KNHANES III-IV), 2008-2011, we identified the 8,156 individuals over 50 years old who have been tested the dual-energy X-ray absorptiometry (DXA). Gastric cancer survivors (n = 103) who had a history of gastric cancer in questionnaire were defined as case. Control subjects were matched to case subjects by age (plus or minus 1 year) and sex with 1:5 ratio. Osteopenia ( -2.5 < T-score < -1.0 ) and osteoporosis (T-score ≤ -2.5) were used to define the status of bone mass. We performed multinominal logistic regression to compare the risk for osteopenia and osteoporosis between case and control. Results: After adjusting for sex, age, body mass index, smoking status, alcohol consumption, physical activity and bone health related history (history of fracture or family history of osteoporosis), there was a significant high risk for osteopenia (adjusted relative risk (RR) = 2.90; 95% confidence interval (CI) 1.16–7.25) and osteoporosis (adjusted RR = 4.63; 95% CI 1.12–13.3) in gastric cancer survivor. The risk for osteoporosis was most prominent for femur total in gastric cancer survivors (adjusted RR = 16.3; 95% CI 3.35–82.6). In addition, the serum Vitamin D level was lower in gastric cancer survivors (20.3 ± 0.5 IU vs 17.5 ± 1.2 IU, p-value = 0.011). Conclusions: Gastric cancer survivors showed significantly high risk for osteoporosis. Our finding clinically implies the importance of managing osteoporosis in gastric cancer survivors.[Table: see text]