Abstract: Objective To explore the effects of neoadjuvant chemotherapy on the operative complications of advanced gastric carcinoma. Methods According to random number table method, 145 patients with advanced gastric carcinoma hospitalized in the Gastrointestinal Surgery Department of The First Affiliated Hospital of Fujian Medical University from Sep 2009 to Jul 2013 were randomly divided into two groups, one group (62 cases) received neoadjuvant chemotherapy and surgery, and the other group (83 cases) received conventional surgery. Operative complications in two groups were compared. Results Between the two groups, the differences of general conditions before operations and incidence rate of main operative complications had no statistical significance(P>0.05). Postoperative white blood cells of neoadjuvant chemotherapy group after 7 days were significantly higher than those of preoperative and corresponding period of conventional surgery group, with statistically significant difference(P＜0.05). Operation cure rate of neoadjuvant chemotherapy group was higher than that of conventional surgery group, with statistical significance(P＜0.05). Conclusion Neoadjuvant chemotherapy is helpful to improve operation cure rate without increasing the risk of postoperative complications.