Abstract: In recent years, neoadjuvant therapy, which can reduce the tumor stage, increase the surgical resection rate and the proportion of radical resection, reduce the risk of tumor recurrence and metastasis thus bringing survival benefit for local advanced gastric cancer patients, plays increasingly important roles in the comprehensive treatment of gastric cancer. In China, the early diagnosis rate of gastric cancer is particularly low and most patients with gastric cancer are diagnosed as locally advanced. Therefore, it is of crucial importance to discuss the current status and challenges of neoadjuvant therapy in gastric cancer. Combined with the existing clinical research results and guidelines and consensus, the authors analyze the application of neoadjuvant therapy in the comprehensive treatment of gastric cancer. Currently, more high‑quality clinical trials are still needed to answer the questions related to neoadjuvant therapy of gastric cancer, such as the indication and regimen, and the optimal cycles and doses of agents, combination of targeted therapy or immunotherapy. Furthermore, how to tailor the individualized treatment strategies according to the pathological stages, molecular characteristics and gene polymophism of patients are still the problems unsolved nowadays. The authors comprehensively analyze the literature at home and abroad to deeply explore the current status and challenges of neoadjuvant therapy in gastric cancer.