ObjectiveTo explore feasibility and security of conversion chemotherapy of stage Ⅳ gastric cancer.MethodThe research progresses of conversion chemotherapy of stage Ⅳ gastric cancer were summarized by reading relevant literatures.ResultsThe prognosis of stage Ⅳ gastric cancer was poor, its correct treatment strategy was still controversial. At present, the palliative chemotherapy and targeted therapy were mainly used for it. In recent years, the development of chemotherapeutic drugs had improved the survival of some patients who showed the excellent chemotherapy response rate and subsequently undergone surgery, which promoted the derivation of the concept of conversion therapy. For the patients with initial unresectable stage Ⅳ gastric cancer, these patients could get better pathological reaction and then perform R0 operation through the comprehensive measures such as the preoperative chemotherapy, so that the patients could acquire relatively longer survival time. The previous studies indicated that the single unresectable factor, chemotherapy response rate, and whether R0 resection were the important predictors of prognosis for patients with stage Ⅳ gastric cancer.ConclusionsConversion therapy is still at initial stage. Different conversion chemotherapy regime has different response rate. Moreover, expert consensus on case selection, chemotherapy regimen are absent due to lack of high-quality, multi-center, large-sample data. So higher levels of clinical randomized controlled trials are needed to support and guide this practice. In a word, conversion therapy of stage Ⅳ gastric cancer requires multi-disciplinary efforts to carry out an optimal classification to select out suitable candidates, which may provide efficient guidance for comprehensive treatment for stage Ⅳ gastric cancer.