A case of effective paclitaxel therapy for gastric cancer with brain metastasis is reported. The patient was a 76-year-old male, who underwent total gastrectomy for advanced gastric carcinoma with direct invasion of the pancreas. One year and six months later, he was resected for a right temporal-occipital brain metastatic tumor, and local cerebral irradiation at 30 Gy was performed. Four months later, new multiple brain metastases were detected in the cerebellum. We tried paclitaxel administration. It was continued on a weekly basis at 70 mg/m(2), and the brain metastases continued to diminish; in addition, gamma knife therapy led to an improvement in the quality of life. Although the patient had been told that he had only a month to live, he was improving dramatically. However, he died of sepsis due to Fournier's gangrene about 5 months later. Paclitaxel seems to have a strong antineoplastic effect by brain metastasis of gastric cancer.