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Summary: Objective:: The National Library of Medicine''s Unified Medical Language System (UMLS) is a rich source of knowledge in the biomedical domain. The UMLS is used for research and development across wide range of different applications. In this paper, we evaluated the coverage of UMLS as compared with medical terms extracted from Korean medical records and identified differences in concept representation between two terminology sets. Design and measurement:: We measured the concept coverage of the UMLS. For this study, we mapped the clinical terms extracted from the discharge records of Seoul National University Hospital (SNUH) to the UMLS. Results:: Thirty-five percent of the entry terms used in chief complaint of SNUH were conceptually matched with the UMLS ‘Sign or Symptom’ concepts. Fifty-eight percent of the terms were found to be matched with the UMLS ‘Disease or Syndrome’ concept rather than the ‘Sign or Symptom’ concept. The remaining 7% were not found in the UMLS concepts. We then analyzed some of different expression patterns used by the two term sets and addressed issues to be taken into consideration. Conclusion:: We found out that the UMLS was comparable with Korean medical records, since most of concepts of Korean medical records were covered with the UMLS concepts. [Copyright &y& Elsevier]