Abstract: In China, most patients with gastric cancer are diagnosed at an advanced stage, making comprehensive treatment for advanced gastric cancer crucial. Systemic pharmacotherapy is the mainstay treatment for such patients. Guided by the concept of precision medicine, trastuzumab deruxtecan for HER2-positive patients and immunotherapy, such as nivolumab in combination with chemotherapy, have significantly improved the survival outcomes of patients with advanced gastric cancer. Furthermore, local therapy, nutritional support, and psychosocial interventions have enhanced patient quality of life. Herein, the perioperative treatment strategies, feasibility of reduced lymphadenectomy, and surgery-sparing approaches are explored, emphasizing the importance of a multidisciplinary treatment models to achieve individualized and precise treatment for patients with advanced gastric cancer.