We evaluated the results of hepatic arterial infusion chemotherapy (HAIC) using implantable reservoir for gastric cancer patients with unresectable liver metastases. Twenty-eight patients (19 with synchronous liver metastases, 6 patients with recurrent hepatic tumors, and 3 patients with high risk factors of liver recurrence after curative surgery) were treated with HAIC. The canula was inserted into the hepatic artery during primary surgery for 19 patients and during angiography for 7. The combination of anti-cancer drugs, such as, MMC + 5-FU (6 cases), ADM + 5-FU (14 cases), 5-FU + ADM + MMC (5 cases), and CDDP (3 cases) was administered by the intra-arterial route to out-patients every one or two weeks. RESULTS The response rate of the metastatic liver foci in evaluable patients was 32.0% (1 CR + 7 PR/25). The median survival time (MST) of all patients was 294 days, and there were only two 5-year survivors treated to prevent recurrence. The 2-year survival after HAIC was 10.5% for the synchronous liver metastatic group and 53.3% for the metachronous group. The MST of responders was 94 days longer than that of non-responders, but there was no significant difference statistically. The remote survival of the patients whose palliative factors were liver metastases alone was significantly better than that of the patients with hepatic and extrahepatic palliative factors: the MST and 1-year survival was 329 days and 140 days, and 17.9% and 13.3%, respectively (p < 0.05). In conclusion, the clinical effect of HAIC was not sufficient. But the improvement of survival among patients without extrahepatic lesions as a palliative factor, and preventive HAIC was recommended.