Squamous lesions of the stomach are rare and of controversial origin. They include squamous cell carcinoma (SCC) and squamous metaplasia (SM). Gastric SCC comprises 0.2% to 1.4% of gastric carcinomas. 1,2 Because its clinical, radiologic, and endoscopic features are nonspecific, diagnosis relies on microscopic examination of gastric biopsy. 1,2 It is a diagnosis of exclusion. Invasion from adjacent organs and metastasis from distant sites should be ruled out by endoscopy and radiology, which should demonstrate a primary gastric mass or ulcer. Histologically, absent malignant glandular elements, negative mucin stains, negative glandular immunomarkers such as CK7, CK20, MUC2, and MUC5A with positive squamous immunomarkers such as P63 and CK5/6 should rule out gastric adenosquamous carcinoma or poorly differentiated adenocarcinoma (Figure 1). SM is much rarer than the well-known chronic