Over the past few years, progress has been made in surgery and adjuvant therapy in treating gastric cancer. As the standard mode of surgery, the D2 or extended radical surgery does not apply to all cases of gastric cancer. Thus, a tailored approach depending on the stage of the disease is needed. Early gastric cancer may benefit from resection by endoscopic or laparoscopic techniques and may also be suitable for function-preserving procedures. The multi-visceral resections and extended excision for gastric cancer has always been controversial. The preoperative treatment of locally advanced tumors increases the resectability of the tumors. Postoperative chemo-radiation or chemotherapy in gastric adeno-carcinomas showed increased rates of survival among patients with gastric cancer. With the introduction of brand-new targeted agents combined with conventional chemotherapy, multi-mode therapeutic regimens are likely to emerge as global standards for advanced gastric carcinoma treatment. The cytoreductive surgery combined with peri-operative intra-peritoneal chemotherapy has been recommended as a kind of therapy for treating patients with peritoneal carcinomatosis.