Abstract: Objective To investigate the efficacy and safety of oxaliplatin in combination with capecitabine as first-line chemotherapy for patients with metastatic gastric cancer. Methods Twenty-seven chemotherapy-na ve patients with metastatic gastric cancer participated in the study. They received oxaliplatin 130 mg/m² as 2-hour intravenous infusion on day 1 and oral capecitabine 2 000 mg/m² divided into two daily doses on days 1~14 every 21 days (XELOX regimen). Maximum 8 cycles were given. Results Twenty-seven patients completed 124 cycles of chemotherapy with a median number of five cycles. All patients could be evaluated for efficacy. The response rate was 44.5% (95% confidence interval: 25.8%~63.2%), with 12 partial responses (44.5%), 8 stable diseases (29.6%), and 7 progression diseases (25.9%). At 9.2 months mean follow-up, median time to progression and overall survival were 5.0 (95% confidence interval: 2.6~7.4) and 9.7 months (95% confidence interval: 6.5~12.9) respectively. Common adverse events included bone marrow suppression, peripheral neuropathy, diarrhea, nausea/vomiting and hand-foot syndrome. There was no treatment-related death. Conclusion XELOX regimen is active and well-tolerated as first-line chemotherapy for patients with metastatic gastric cancer.