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Background: There is evidence of a direct relationship between peptic ulcer disease (PUD) and the risk of gastric cancer. This study determined the prevalence of gastric cancer in individuals with solitary proximal or distal gastric ulcers admitted to Shahid Rahimi Hospital in Khorramabad, Iran, from 2019 to 2021. Materials and Methods: In this cross-sectional study, 635 patients were included. Age group and sex as well as data related to the year of admission, pathological examination, and location of the ulcer, were recorded in a researcher-made checklist. Data were analyzed using the SPSS software version 22 at a significance level of 0.05. Results: Out of the 635 patients, 66.3% (421) were male, and 33.7% (214) were women. The mean age was 62.5±17.7 years. Overall, 16.7% of patients with gastric ulcers were diagnosed with gastric cancer by pathological examination. The frequency of malignancy was highest in the 80 years and older age group. There was a considerable association between malignancy and age group (P˂0.001; df=4; χ2=27.24). There was no significant association between malignancy and sex (P=0.144). A significant relationship was observed between malignancy and ulcer location (P˂0.001). Proximal ulcers were malignant in 24.6% of the cases (n=74), while distal ulcers were malignant in 9.6% (n=32). Conclusion: Older patients, men, and patients with gastric ulcers are more likely to develop gastric cancer. Therefore, more effective strategies should be developed to prevent this fatal condition. [ABSTRACT FROM AUTHOR]