Abstract: Surgery is one of the main ways to treat gastric cancer, and standard intraoperative lymph node dissection is particularly important. However, performing para-aortic lymph node dissection (PAND) in patients with gastric cancer is still controversial. The significance of preventive PAND has been denied. But further research is needed to confirm the effectiveness of therapeutic PAND. Preoperative chemotherapy combined with surgery may be the standard treatment strategy for advanced gastric cancer with para-aortic lymph node metastasis in the future. This article reviews the studies of PAND for gastric cancer to provide guidance for clinical practice.