Abstract: To investigate survivin expression in the peripheral blood of gastric cancer patients and whether it can predict the metastasis and recurrence of gastric carcinoma. Methods: Reverse transcriptase polymerase chain reaction and enzyme-linked immunosorbent assay ( RT-PCR-ELISA ) was used to assess the expression of survivin mRNA in the peripheral blood of patients with gastric cancer. The correlation between survivin expression and the clinicopathologic features was then calculated. During a follow-up period of 36 months, the correlation of time of metastasis and recurrence with survivin expression was analyzed. Results: The survivin mRNA expression rate in the peripheral blood of the 53 cases of patients with gastric cancer was 60.4% ( 32 cases ). The expression rates for tumors >5 cm and ≤5 cm were 78.3% and 46%, respectively. The expression rate among patients with infiltrated plasma membranes was 74.2%, which was higher than that in the remaining patients ( 33.3% ). With lymph node metastasis, the expression rate was 75.0%, which was higher than in those without lymph node metastasis ( 29.4% ). Conclusion: Survivin expression in the peripheral blood is correlated with the size, the presence of infiltration, lymph node metastasis, and clinical stages, but not with the primary tumor site or the degree of tumor differentiation. In addition, survivin expression can indicate that patients have a higher risk of metastasis and recurrence. Therefore, survivin expression in the peripheral blood might be a referenced indicator for evaluating the biological behavior and prognosis of gastric cancer.