Objective To evaluate the risk of colorectal neoplasia among patients with gastric or duodenal adenoma. Methods We retrospectively reviewed 39 patients with gastric or duodenal adenomas between 2007 and 2011 as the study group. A total of 78 patients without upper gastrointestinal adenomas who underwent colonoseopy were included as a control group. Colonoscopie findings were compared between the two groups. Results Positive finding rate of colorectal neoplasia in study group was 51.3% (20/39) , with adenomas in 38.5% (15/39) and cancer in 12. 8% (5/39), which were all significantly higher than those of the control group, 14. 1% (11/78) ( P 〈 0. 001 ), 12. 8% (10/78) (P 〈 0. 05 ) and 1.3% (1/78) (P 〈 0. 05 ), respectively. The results were similar when upper digestive tract was further divided into stomach and duodenum(50. 0% vs. 12. 5% and 52. 2% vs. 15.2% ). Conclusion Patients with gastric or duodenal adenomas are at a significantly higher risk for colorectal neoplasia. Colonoscopy should be recommended for these patients. Key words: Gastric adenomas ; Duodenal adenomas ; Colorectal neoplasia; Colonoscopy