Background: No consensus has been reached on the management of gastric hamartomatous polyps, owing to a lack of knowledge of the long-term outcome of after removal of these polyps. Methods: A retrospective database review was performed in a tertiary referral hospital between 1995 and 2011. Thirty-two consecutive patients who were diagnosed with gastric hamartomatous polyps were managed by surgical or endoscopic resection. Results: Patients developed the disease predominantly in their seventh and eighth decades of life. The tumors were located mostly in the antrum, and the diameter ranged from 5 to 52 mm. In one patient, adenocarcinoma in situ accompanied by gastric hamartomatous polyp was diagnosed by pathologic examination after endoscopic mucosal resection (EMR).There were no significant differences in the rates of technical success, treatment success, complications, or recurrence between surgery and endoscopic excision. The endoscopic excision group had a shorter mean post procedure hospital stay than the surgery group (7.2 vs. 21.4 days, P = 0.002). Conclusions: Endoscoipic resection for gastric hamartomatous polyps is an effective procedure and a less-invasive alternative to surgery. © 2013 JMS.