PURPOSE: The surgical techniques and postoperative care for gastric cancer have significantly improved in recent years. However, the incidence of several complications that can result in relatively increased mortality remains high. The aim of this study was to evaluate the risk factors associated with postoperative morbidity in surgery for gastric cancer. METHODS: Four hundreds and one consecutive patients, who underwent surgery for gastric cancer at National Medical Center between January 1994 and December 2002, were reviewed. RESULTS: The overall morbidity and mortality rates were 10.2 and 1.5%, respectively. A univariate analysis of multiple clinical variables revealed that age, leukocyte counts, albumin, protein, comorbid disease, combined resection, operation time, blood loss, operation type, curability, extent of lymph node dissection and stage were significantly associated with morbidity. However, a multivariate analysis showed that comorbid diseases and low curability were independent factors associated with morbidity (P<0.05). CONCLUSION: In patients with comorbid diseases and a noncurative resection, the complication rate was significantly higher. More attention should be paid to the early diagnosis, preoperative evaluation and intraoperative caution of patients with preoperative risk factors.