Currently, the treatment of gastric cancer includes surgery, chemotherapy and radiotherapy, and the survival of patients has been greatly improved. However, 5-15% of patients still have liver metastasis, which means advanced disease, short survival time and poor prognosis. There are some special modes of treatment for this group of patients, which are clinically important because they can be beneficial if selected appropriately. (The reason why surgery for liver metastases from gastric cancer is rarely mentioned in textbooks and treatment guidelines is that liver metastases are often accompanied by lesions outside the liver, such as peritoneal metastases, lymph node metastases and distant metastases from other organs. Therefore, liver surgery is performed in only 1 in 5 patients. Intrahepatic recurrence occurs in about 2/3 of patients after surgery, suggesting that occult intrahepatic micrometastases may already be present at the time of liver surgery. To date, only a few studies have suggested that resection of liver metastases can provide satisfactory clinical benefit. When patients with liver metastases from gastric cancer undergo hepatic lesion resection, those patients without peritoneal metastases and gastric cancer lesions without vascular and lymphatic vessel invasion should be considered. For metastases located in one lobe of the liver or metastases less than 4 cm in diameter and isolated lesions in the liver, surgical resection can be recommended, and adjuvant chemotherapy is required after surgery. (II) Radiofrequency ablation Radiofrequency ablation (RFA) is widely used for primary liver cancer or metastatic liver cancer because of its safety and operability. A prospective study evaluated the efficacy of hepatic arterial infusion chemotherapy (HAIC) combined with RFA via an intracorporeal implantable pump. Seven patients with liver metastases from gastric cancer, all without extrahepatic metastases and with liver lesions ranging from 3.2 to 6 cm, were first treated with HAIC, with regression of the mass to less than 3 cm, followed by RFA for residual liver lesions, which showed complete tumor regression with a median survival time of 16.5 months.RFA can be recommended as an alternative to surgery as a palliative treatment for advanced gastric cancer where surgery is difficult. The size of hepatic metastatic lesions is the main factor whether RFA treatment can achieve complete control. It is usually believed that those with masses less than 2.5 cm in diameter have 90% chance of complete destruction by RF, while those with masses larger than 5 cm in diameter are not completely controlled by RFA for about 50% or more, therefore, hepatic arterial infusion chemotherapy combined with RF or microwave ablation is a better choice for patients with masses larger than 5 cm. (iii) Hepatic artery chemo-perfusion/hepatic artery chemo-embolization The catheter is selectively or super-selectively inserted into the target artery of liver tumor blood supply for hepatic artery chemo-perfusion, thus creating a high concentration of local drugs in the liver; or injecting appropriate amount of anti-cancer drugs and embolic agents to occlude the target artery, which plays the role of chemo-embolization and causes ischemic necrosis of tumor tissues, and is used to treat non-surgically resectable liver metastatic lesions with less toxic side effects. and have less toxic side effects. Several clinical trials on hepatic artery infusion chemotherapy in liver metastases from gastric cancer have shown that this method has some growth control effect on metastatic lesions, but does not result in significant survival prolongation. With the development of HAI technology and materials, degradable starch microspheres (DSM) began to be widely used, and some scholars applied hepatic artery perfusion chemotherapy with DSM to treat 8 patients with liver metastases from gastric cancer, and its efficiency reached 62.5% and survival was as high as 36.1 months, which is only a small sample report and needs to be confirmed by expanding the sample. However, no matter what kind of hepatic artery perfusion method is used, it is only a local treatment for the liver, and at present, the majority of scholars believe that this method is only an adjuvant on the basis of systemic chemotherapy. (iv) Systemic chemotherapy Although the above-mentioned local treatment modes are effective for patients with liver metastasis of gastric cancer, the occurrence of liver metastasis of gastric cancer indicates that the patient is in advanced stage of the disease, therefore, systemic chemotherapy or molecular targeted drug therapy is the basic treatment for this group of patients. There is no unified standard for optimal treatment of gastric cancer with liver metastasis, and it is necessary to combine patients’ specific conditions and multidisciplinary participation to achieve clinical benefits; meanwhile, further research and understanding of the biological mechanism of gastric cancer liver metastasis is needed to identify targeted targets for treatment; and large-scale clinical trials should be conducted to provide a basis for the formulation of correct treatment guidelines.