To evaluate pepsinogen 1 (Pg 1) level in serum and pepsinogen 1 to pepsinogen 2 ration (Pg 1/2) in patients with AG and GC and compare them to gold standard endoscopic examination in those patients, to detect the sensitivity and specify of these markers to evaluate their value as a future seromarker or tumor marker. Patients and Method: This was an observational case-control comparative study that included 60 patients diagnosed with atrophic gastritis and gastric carcinoma. A clinical and endoscopic examination were used to make the diagnosis, and gastric biopsies were examined histologically to confirm it. Two separate groups of patients were formed, with 30 patients involved within group 1 having AG and 30 patients in group 2 having GC. As a control group, 30 healthy volunteers were enlisted. Informed written consent will be taken from all patients. Results: Serum Pg 1 and Pg 1/2 in AG and GC patients were comparable (p= .098, 0.976, respectively), however, compared to healthy controls, they were statistically considerably lower (p< 0.001 for all). The optimum cut-off values for diagnosing AG or GC were Pg 1 18.96 and Pg 1/2 2.25; these values may produce a 100% sensitivity (94-100), 100% specificity (88.4-100), positive predictive value (PPV) that was 100%, and 100% negative predictive value (NPV).