Abstract: Gastric mixed adenoneuroendocrine carcinomas (G-MANEC) are an infrequent variant of gastrointestinal tumors. Despite their relatively low occurrence, there has been a noticeable upward trend. G-MANEC exhibit a highly invasive nature, frequently leading to lymphatic and distant metastases, which ultimately result in unfavorable prognosis. Consequently, this condition has garnered considerable interest among researchers. G-MANEC are characterized by the presence of adenocarcinoma and neuroendocrine carcinoma components, with each component comprising at least 30% of the tumor. In recent years, a growing body of knowledge regarding G-MANEC has led to a more comprehensive research approach towards this type of carcinoma. Nevertheless, there has been a notable deficiency to date in the examination of lymph node metastatic aspects of G-MANEC, which poses several pressing challenges that demand immediate resolutions. This review aims to systematically analyze previous case reports and studies on mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) while incorporating research on gastric cancer. This study focuses on various aspects of G-MANEC, including the epidemiology, biological origin, diagnosis, patterns of lymph node metastasis, relationship with hematogenous metastasis, association between lymphatic and distant metastases, and treatment. The objective is to offer guidance for future research endeavors concerning G-MANEC.