Every year, almost 1 million new cases of gastric cancer are diagnosed worldwide. In Europe and North America, overall 5‑year survival is only about 20–25%. This is mainly because more than 70% of Western patients are diagnosed at advanced stages, with locally advanced tumours and/or distant metastases. Complete surgical resection of the primary tumour including D2 lymphadenectomy is the cornerstone of curative treatment. For resectable tumours, perioperative chemotherapy increases overall 5‑year survival by 15%. In the palliative setting, additional therapeutic options including molecular targeted therapies improve survival, quality of life and symptom control. Adenocarcinomas of the oesophagogastric junction differ from gastric cancers in terms of aetiology, diagnostic approach and—according to tumour localisation—partly in terms of treatment; they therefore require a separate discussion.