Due to improved perioperative management resection of gastric carcinoma in elderly patients is the treatment of choice. Although these patients often have age-related cardiovascular and pulmonary morbidity, postoperative morbidity and mortality even after extensive resections is low. The survival data are absolutely comparable to younger patients, and the prognosis is best after R0-resection which, therefore, should be the goal of surgery for gastric carcinoma in aged patients.