Objective: Although gestational surrogacy offers several advantages, this procedure has given rise to some ethical and legal issues.We aimed to clarify the factors affecting the attitude of the Japanese toward gestational surrogacy. Design: Cross-sectional study. Setting and participants: Nationwide opinion surveys concerning assisted reproductive technologies (ART) were carried out in 1999 and 2003. Participants included 2568 and 3647 people from the general public surveyed in 1999 and 2003, respectively (1564 people received only the questionnaire, and 2083 people received a questionnaire and brochure about ART). Main outcome measure: Multivariateadjusted odds ratio and 95% confidence interval from logistic regression models for factors affecting the attitude toward gestational surrogacy. Results: In both surveys, approximately half of respondents approved of gestational surrogacy; 20–30% disapproved of the procedure. People with high socioeconomic status clearly expressed their opinion on this issue. A liberal attitude toward gender role promoted approval of gestational surrogacy; a liberal attitude toward family had the opposite effect. Conclusion: Our findings suggest that socioeconomic status affects people’s Abstract of the 8th Royan International Twin Congress, Tehran, Iran, 5-7 September 2007 Yakhteh Medical Journal, Vol 9, Sup 1, Summer 2007 41 expression of their opinion regarding this issue, while attitudes toward this procedure were influenced by individual belief. Considering socioeconomic status and diversity of individual belief is required for further discussion on this topic.