Abstract: Objective To explore clinical efficacy and safety of raltitrexed combined with docetaxel in the treatment of advanced gastric carcinoma. Methods Ninety patients with advanced gastric carcinoma were randomly divided into groups A and B. Group A (45 cases) was given the chemotherapy of raltitrexed combined with docetaxel, while group B (45 cases) given docetaxel alone chemotherapy. The therapeutic effects, toxic and side effects of 2 groups were compared after 2 cycles of treatments. Results The therapeutic effects of all patients after chemotherapy were evaluated. The total effective rate (53.33%) in group A was significantly higher than that of group B (31.11%), and the difference showed statistical significance. Toxic and side effects of 2 groups mainly included myelosuppression, nausea and vomiting, alopecia, joint pain, peripheral neuritis and oral mucositis, and the incidences of myelosuppression, joint pain, increased transaminase and anemia in group A were higher than those in group B, but there were no signifi cant difference. There were no patients whose chemotherapy was delayed due to toxic reactions, and no chemotherapy-related death. Conclusion The therapeutic effects of raltitrexed combined with docetaxel in the treatment of advanced gastric carcinoma are better than that of docetaxel alone, and its toxic and side effects are slight, so it is worthy of being popularized and applied in clinic.