Gastric cancer has a high morbidity and mortality. The rate of metastasis and recurrence in early gastric cancer that has undergone radical surgery is low. However, the rate of metastasis and recurrence in advanced gastric cancer (AGC) after curative gastrectomy is high. The reason is that surgical treatment cannot eradicate tumor micro-metastases. Intraoperative arterial infusion chemotherapy (IAIC) can create a high concentration chemotherapy circumstance around the tumor and surrounding tissues, which will kill residual cancer cells following curative gastrectomy. AGC patients after R0 resection with D2 lymph node clearance and IAIC can achieve a radical cure with regard to both macroscopic and microscopic evidence, which will decrease the rate of metastasis and recurrence, prolong patients′ survival time, and improve their quality of survival. IAIC was first developed in the 1990 s, and with nearly 30 years of development, its clinical efficacy has been recognized. However, there is still no large randomized trial evidence to support its efficacy, and it is still not optimized on how to choose blood vessels for perfusion and how to choose a proper chemotherapy regimen. This article summarizes the application of IAIC in AGC patients.