Peptic ulcer disease (PUD), though more common in adults, the incidence in children is significant. Helicobacter pylori infection is the most common etiology for PUD in children. Other causes include the use of NSAIDs, steroids, immunosuppressive drugs, or stressful events such as burns or head injury. Upper gastrointestinal endoscopy with gastric biopsy for detecting H. pylori is the standard diagnostic workup. The mainstay of treatment of PUD includes histamine 2 receptor antagonists and proton pump inhibitors (PPIs). Helicobacter pylori infection should be treated with a combination of a PPI and antibiotics. Surgical intervention is occasionally required in complicated cases with massive, uncontrollable gastrointestinal hemorrhage or in cases with gastroduodenal perforation. Smooth foreign bodies that reach the stomach will usually pass through the gastrointestinal tract, and observation alone is sufficient. Sharp objects, button batteries, or magnets usually require endoscopic removal. Bezoars in the stomach may be removed endoscopically if small; however, they usually require surgical removal. Gastric volvulus may be primary due to lax attachments of the stomach or secondary to diaphragmatic defects. It is classified as organo-axial or mesentro-axial. Surgical correction by gastrostomy or gastropexy, either open or laparoscopic, is generally successful. Pyloric atresia is a very rare entity that may be confused with hypertrophic pyloric stenosis and usually requires gastro-duodenostomy for treatment. Gastric perforation and necrosis are seen in preterm neonates related to perinatal stress and gut ischemia, or rarely, it may be iatrogenic. Primary closure in isolated perforations and partial gastrectomy for more extensive disease are required for treatment.