Despite recent progress in surgery and chemotherapy, advanced gastric cancer carries a poor prognosis. Although several antitumor agents have some clinical activity, responses are usually of short duration and fail to improve survival. Combination chemotherapy regimens containing fluorouracil (5-FU) and cisplatin (Platinol) frequently result in higher response rates, but fail to significantly alter the ultimate course of the disease. Tegafur and uracil (UFT) have been extensively studied in gastric cancer in Japan. In responding patients, single-agent therapy results in a 1-year survival of 47%. Studies using combination regimens with UFT are currently performed in Europe, and data from Japan demonstrate that UFT can be safely combined with a variety of other agents. However, the exact contribution of UFT in these combinations will need to be evaluated further. The present review summarizes the use of UFT alone or in combination, as well as in the neoadjuvant and adjuvant settings, in the treatment of patients with advanced gastric cancer.