Introduction: Swelling in the epigastrium is caused by those organs anatomically present in the region as well as by other organs in the other regions. This study was done with an interest to know the clinical presentation of the various cause of the epigastric swelling. Methods: Fifty-two cases with a pathological swelling in the epigastrium, who were admitted to tertiary care center, were randomly selected those cases were studied during their stay in the hospital. In this study, the swelling from stomach and pancreas were included aged more than 12 years and the rest excluded. Relevant investigations were made and the diagnosis confirmed