Most gastric cancers in the USA present with advanced disease. Risk factors include environmental and genetic factors. Common tests for workup and staging include endoscopic ultrasound, CT, and PET scan. For very early-stage disease, endoscopic resection may be feasible. For many patients with potentially curable stage, an optimal strategy is perioperative chemotherapy with FLOT. Operation for proximal cancers is total gastrectomy whereas mid-to-distal cancers are removed with partial gastrectomy. Extended lymphadenectomy is associated with improved survival. Metastatic disease is not curable.