The purpose of this study was to investigate relationships between green tea consumption and gastric cancer development. A population-based case-control study including 200 cases and 200 controls was conducted in the southwest area of China from May 2010 to February 2011. A self-designed questionnaire was used to collect data on factors influencing gastric cancer development, including tea drinking, conditional logistic regression being used to calculate odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs). Cases with higher economic status had a reduced risk of gastric cancer, while those with cancer family history, drinking and smoking showed increased risk. Hot and very hot tea temperature was significantly related to high risk of gastric cancer with ORs (95%Cl) of 1.82 (1.03-3.52) and 3.07 (1.78-7.36), respectively. Further analysis indicated elevated risk of gastric cancer in former drinkers, former smokers and current drinkers when the measured tea temperature was hot. Drinking tea at high temperature increases the gastric cancer risk, especially in drinkers and smokers.