Abstract: Gastric cancer is a common malignant tumor in China. Currently, surgical resection is the only curative method to cure gastric cancer. However, patients with locally advanced gastric cancer (LAGC) have poor efficacy and high risk of recurrence after surgery alone. Neoadjuvant therapy can reduce tumor stage, increase R0 resection rate, reduce the risk of local and distant recurrence, and prolong survival in some patients, which have become an important part of LAGC treatment. With the continuous development and extension of neoadjuvant therapy, various clinical trials and new treatment concepts have emerged, and the mode of treatment of LAGC has changed from single chemotherapy treatment to new modes such as neoadjuvant radiotherapy, neoadjuvant chemotherapy combined with targeted therapy, and neoadjuvant chemotherapy combined with immunotherapy. In this study, we review the progress and current controversies of neoadjuvant treatment for LAGC.