Abstract: Objective To investigate the survival and safety of capecitabine maintenance chemotherapy after the first-line fluorouracil/oxaliplatin chemotherapy for patients with advanced gastric cancer(AGC). Methods A total of 102 initial treatment AGC patients accepted the combined chemotherapy of fluorouracil/oxaliplatin for 4-8 cycles. The patients who responded to the therapy were assigned to either the group with capecitabine maintenance chemotherapy (1.0 g/m² po bid d1-d14, repeated every 3 weeks) or the observation group with follow-up. The maintenance therapy was continued until disease progression or intolerable toxicity. Results The response rate(RR) and disease control rate(DCR) after the first-line fluorouracil/oxaliplatin chemotherapy were 41.2% and 77.5%, respectively. Among the 79 patients who responded to the combined therapy, 44 patients entered the maintenance group and 35 patients entered the observation group. During the follow-up, the differences of RR and DCR between two groups were not significant(P＞0.05). The median progression free survival (mPFS) in maintenance group (7.8 months) was longer than that in observation group (5.8 months)(P＜0.05). The median overall survival (mOS) were 17.1 and 13.4 months in maintenance group and observation group respectively, with significant difference(P=0.041). As for the adverse events, the incidence rate of hand-foot syndrome in maintenance group was higher than that in observation group(P＜0.05), but only one patient discontinued treatment. The differences of other adverse events, such as myelosuppression, nausea and vomiting, diarrhea, hepatorenal dysfunction, peripheral neurovirulence and stomatitis, were not significant between two groups(P＞0.05). Conclusion Capecitabine maintenance chemotherapy could prolong progression free survival and overall survival in AGC patients who respond to first-line fluorouracil/oxaliplatin chemotherapy.