Neoadjuvant chemotherapy is an effective supplement to surgical treatment. The application of neoadjuvant chemotherapy before surgical treatment for moderately advanced gastric cancer can effectively control tumor disease progression, induce tumor volume reduction or clinical stage downgrading, and help improve the absolute radical resection rate. Chemotherapy is a systemic therapy, which can eliminate potential micrometastases, reduce intraoperative tumor cell dissemination, and lower postoperative metastasis and recurrence rates. It can play a role in stabilizing or improving the tumor of some gastric cancer lesions with high malignancy, extensive infiltration and rapid progression. The relative anatomical clarity and absence of obvious tissue edema during surgery after the reduction of tumor lesions reduces the difficulty of surgery and facilitates the smooth implementation of surgery. Pre-operative neoadjuvant chemotherapy for gastric cancer mostly adopts FOLFOX regimen, whose adverse reactions include gastrointestinal reactions, bone marrow suppression and neurological toxicity, but the symptoms are mostly mild toxic reactions, which can be relieved after prophylactic medication and symptomatic treatment. When the surgery is performed about 2 weeks after the cessation of chemotherapy, the adverse reactions caused by chemotherapy have disappeared and the patient’s general condition is good, which generally does not affect the smooth implementation of the surgery. The operating time and intraoperative bleeding of preoperative neoadjuvant chemotherapy patients were significantly less than those who underwent direct surgery. This result suggests that preoperative neoadjuvant chemotherapy can help control gastric cancer and reduce the difficulty of surgery and intraoperative bleeding. The incidence of postoperative complications in preoperative neoadjuvant chemotherapy patients was significantly lower than that in direct surgery patients, which suggests that preoperative neoadjuvant chemotherapy helps to reduce postoperative complications and has positive clinical significance.