Abstract: Objective To investigate and compare the clinical value of barium X-ray and electronic gastroscopy in the diagnosis of gastric ulcer. Methods One hundred patients with gastric ulcer diagnosed by barium X-ray and electronic gastroscopy from January 2014 to December 2016 were enrolled in the retrospective analysis of clinical data. Based on the final clinical diagnosis results of gastric ulcer, the efficacy of these two methods was investigated, and their respective imaging characteristics were summarized. Results The coincidence rate in the diagnosis of gastric ulcer of barium X-ray examination was 63.00% (63/100), and 100.00% (100/100) of Electronic gastroscopy, There was significant difference in the coincidence rate between the two groups in the diagnosis of gastric ulcer (χ²= 28.970, P<0.05). The coincidence rate of the two methods in the diagnosis of malignant gastric ulcer was 100.00% (5/5). The characteristics of gastric ulcer showed by barium X-ray examination: 80.95% had niches, 9.52% had thin barium-filled niches, 41.27% had "ring" signs at the bottom of niches, 15.87% had bilateral signs, 50.79% had mucosal convergence signs, and 6.35% had transparent thin lines. The characteristics of gastric ulcer by electronic gastroscopy: 64.00% of ulcer basal coating was thick and dirty, mucosal congestion and edema around the lesion; 35.00% of ulcer lesion epithelial regeneration formed red halo, folds concentrated to ulcer; 11.00% of ulcer basal coating was thin, red halo or folds concentrated around the lesion; 5.00% of ulcer basal coating disappeared, leaving a pink or white flat depression/scar in the central area. Conclusion Electronic gastroscopy, compared with barium X-ray, is more accurate in the diagnosis of gastric ulcer; however, barium X-ray is more specific. The sensitivity of the two methods is similar. The barium X-ray and electronic gastroscopy have their own advantages in the diagnosis of gastric ulcer, the latter is more accurate. In clinical work, each patient's specific conditions should be combined with their respective clinical advantages.