Abstract: Gastric cancer is a serious malignancy that endangers human health. Increased rates of chemotherapy-resistant cancer have led to a decrease in the efficacy of treatment. Recent studies found that the presence of hypoxia in the tumor microenvironment was a notable cause of gastric cancer resistance to chemotherapy drugs. The abnormal structure and function of blood vessels in the tumor and the rapid proliferation of tumor cells increase the oxygen consumption of tumor cells, which results in tumor tissue hypoxia. Hypoxic conditions make tumor cells more aggressive, more likely to metastasize and develop resistance to chemotherapy. In this paper, we have reviewed the progress of research into hypoxia-induced chemotherapeutic drug resistance in gastric cancer. The review has covered the causes of hypoxia and the characteristics of the hypoxic microenvironment in gastric cancer, the current situation and causes of hypoxia-induced chemotherapeutic drug resistance in gastric cancer, and the measures to overcome the hypoxia-induced resistance to chemotherapy drugs.