The purpose of the study was to clarify the significance and propriety of radical gastrectomy for elderly patients with gastric cancer. Twenty-two patients over 80 years old were divided into two groups: curative group (curability A & B, n=17) and non-curative group (curability C, n=5), and comparatively studied for perioperative factors, clinicopathological findings, postoperative course and prognosis. The propriety of radical gastrectomy for elderly patients was confirmed because favorable one-year and 5-year survival rates of 94.1% and 66.9% respectively were attained in the curative group. Moreover, early postoperative course in the curative group was uneventful and they had kept high quality of life for a long period though they received severe operative procedures compared with non-curative group. The clinical significance of radical treatment was consequently demonstrated. In conclusion, curative resection with curability A or B is recommended even for the elderly patient if his or her general condition allows, under consideration of determinant prognostic factors which are surely able to prospect preoperatively.