Gastric pacing has been achieved in dogs and humans, but its effects on gastric motility and emptying have not been thoroughly explored. Seven dogs had bipolar electrodes placed 1 and 10 cm proximal to the pylorus for reverse and forward pacing and monopolar recording electrodes and strain gauges placed 3, 5, and 7 cm proximal to the pylorus. After recovery, myoelectrical and contractile activity and gastric emptying of a mixed meal (50 g 99mTc-labeled liver and 250 ml 111In-labeled 5% dextrose broth solution) were measured in each of three conditions: no pacing, reverse pacing, and forward pacing (frequency 0.5 cycles/min above intrinsic pacesetter potential frequency). Reverse pacing reversed the direction of > 90% of antral pacesetter potentials and peristaltic waves in six of seven dogs, prolonged the lag phase of solid emptying, prolonged the half emptying time of solids and liquids, and increased the antral motility index. Forward pacing entrained pacesetter potentials but had no consistent effect on emptying or antral contractions. In conclusion, reverse gastric pacing slows gastric emptying of digestible solids and liquids by reversing the direction of antral peristalsis and increasing the antral motility index, whereas forward pacing has no such effects.