Abstract: A 59-year-old man was diagnosed with gastric cancer and enlargement of the perigastric and celiac axis lymph nodes. CT showed that the patient was of stage cT 4N2M0. Considering the general condition and advanced age of this patient, we administered mFOLFOX neoadjuvant chemotherapy at OXA100 mg/m2 iv d 1 (2hr), CF400 mg/m2 iv d 1 (2hr) 5-FU 2400mg/m2 civ d1 (46hr). After 2 treatment cycles, the tumor size and the dimensions of the enlarged lymph nodes were remarkably reduced. The patient had a partial re-sponse (PR) according to the Response Evaluation Criteria in Solid Tumors (RECIST). A curative resection was achieved with a radical total gastrectomy with D 2 dissection, pancreatic cauda resection and splenecto -my. The pathological stage was pT4N2M0 ( ⅢB). The mFOLFOX neoadjuvant chemotherapy was effective for this patient. The role of mFOLFOX in the neoadjuvant setting for the treatment of advanced gastric cancer re -mains to be elucidated through clinical trials. For patients with locally advanced gastric cancer, in whom R0 re -section cannot be performed, neoadjuvant chemotherapy is a good choice.