Solitary extramedullary plasmacytoma (EMP) is a plasma cell neoplasm without systemic involvement. 80% of these tumors occur in upper airways and oral cavity, only 10% involve the gastrointestinal tract. We report the first case of a primary gastric plasmacytoma (PGP) in an end stage renal disease patient. A 35-year-old Tunisian woman presented to the hemodialysis unit with epigastric pain and hematemesis. She had a medical history of hypertension, intermittent asthma, partial spina bifida, and end stage renal disease. She had been treated with peritoneal dialysis for 5 years, and then switched to hemodialysis. Physical exam was without abnormalities except for a moderate pallor, and decreased dry weight among the last 3 months. Upper gastrointestinal endoscopy revealed a 4cm protuberant lesion in the anterior wall of gastric antrum. The thoracoabdominal CT-scan confirmed the presence of the gastric mass, and didn’t show local adenopathies or distant lesions. A partial gastrectomy was performed. The pathological findings and systemic examination confirmed the diagnosis of solitary gastric plasmocytoma. Follow-up of 1 year after surgery showed no evidence of recurrent plasmacytoma, and the patient was free of symptoms Solitary gastric plasmacytoma is a rare and serious condition. Development of consensus guidelines would offer a better results for the screening and treatment.