〔Abstract〕 Objective To explore the relationship between geriatric nutritional risk index(GNRI) and perioperative nutritional status, postoperative recovery and complications in elderly patients with gastric cancer. Methods In this retrospective study, 212 elderly patients(aged≥60 years) with gastric cancer who underwent gastrectomy were recruited. GNRI was used to retrospectively assess the patients′ preoperative nutritional status, and analyze the relationship between GNRI and perioperative nutritional status, postoperative recovery and complications.The ROC curve was applied to explore the value of GNRI in predicting postoperative complications. Results The incidence of preoperative nutritional risk in elderly patients undergoing gastric cancer surgery was 45.07%. Compared with the patients whose GNRI>98 points, the patients whose GNRI≤98 points had different degrees of decrease in serum total protein, albumin, prealbumin, hemoglobin and lymphocyte counts before surgery, day 1 and day 5-8 after surgery(P<0.05).The patients whose GNRI<92 points had longer postoperative hospital stay than those with GNRI>98 points(P<0.05).With the decrease of GNRI scores, the incidence of complications showed an upward trend(P<0.001). The multivariate analysis of the relationship between GNRI and postoperative complications showed that TNM staging of III-IV and GNRI<92 points were independent risk factors for complications. GNRI had a good predictive value for the occurrence of complications(AUC=0.639, 95%CI: 0.570-0.703,P=0.001, Cut-off value: 92.21). Conclusion GNRI can be used for preoperative nutritional assessment for elderly gastric cancer patients. Patients with GNRI<92.21 points should be actively given nutritional therapy to improve perioperative nutritional status, speed up postoperative recovery, and reduce the occurrence of complications.