Among patients with gastric cancer experienced at the department from January 1980 to December 1991, 30 patients over 80 years of age were subjected to this retrospective study. Macroscopic findings showed that half of their cancers were located in the upper part of the stomach, and over 70% of the cancers were tumorous or expanding types (Bormann type 2 or 3). Histologic findings indicated that 80% of the cancers were well or moderately differentiated adenocarcinomas, and lymph node metastasis was mostly limited in the local area (n0 or n1). The aged patients had multiple dysfunctions in the preoperative examinations shown by ECG, respiratory function, PSP test, serum protein and hematocrit, and postoperative complications including anastomotic leakage, stenosis and respiratory complications frequently occurred compared to the younger patients under 80 years of age. The long-term prognosis was not significantly lower than younger patients in 5 years after the operation, if the curative operation could be done. In the treatment of aged patients with gastric cancer, we strive for curative resection with R₂ lymph node dissection basically, however, the avoidance of postoperative complication by diminished operation with R₁ or R₀ is important for patients whose preoperative examinations indicate multiple organ dysfunction.