Background: Brain metastasis (BM) is a rare but serious neurologic complication of gastro esophageal cancers (GEC). The Disease Specific Graded Prognostic Assessment (DS-GPA) which is based solely on Karnofsky performance scale (KPS) is a commonly used prognostic index in patients with BM. We evaluated DS-GPA and other potential prognostic factors for overall survival (OS) in GECBM at our institution. Methods: With IRB approval, the Cleveland Clinic Brain Tumor and Neuro-Oncology Center’s database was used to identify GECBM patients treated between 2002 and 2014. Overall survival (OS) from the diagnosis of GECBM was the primary endpoint. Cox proportional hazards models with stepwise variable selection were used to identify independent prognostic factors. Results: Sixty three patients with median age of 62 years (range; 33-79), were included for analysis. KPS was 90-100 in 22 patients (38%), 70-80 in 30 (52%) and <70 in 6 (10%) patients. Single BM was noted in 25 (40%), 2-3 BM in 19 (30%) and >3 BM in 19 (30%) patients. Forty nine patients (78%) were symptomatic at diagnosis. Twenty nine (46%) patients had supratentorial BM, 12 (19%) had infratentorial BM and 22 (35%) had both supra-and infratentorial BM at diagnosis. Initial therapy included whole brain radiation (WBRT) in 29 (48%), stereotactic radiosurgery (SRS) in 13 (21%), WBRT + SRS in 6 (10%), Surgery (S) + SRS in 2 (3%), S + WBRT in 9 (15%), S + SRS + WBRT in 1 (2%), while 1 patient received only chemotherapy. Median OS from diagnosis of BM was 4.5 months (95% C.I. 3.4-6.8). In multivariate analysis KPS, number of BM and symptoms were independent predictors of OS. Combining these factors a revised GPA with three groups was defined: unfavorable (total points <10), intermediate (11-13), and favorable (>13 points) with median OS of 2.5, 5.0 and 8.8 months, respectively. Conclusions: A revised DS-GPA for GECBM based on KPS (performance status), number of BM and symptoms is proposed.