Complete response to chemotherapy treatment was achieved in an 86-year-old woman with extensive metastatic gastric carcinoma. Thirty months after the initiation of treatment, the patient continues to be in complete remission. Chemotherapy consisted of a modified FAM regimen (5 FU, mitomycin C, and doxorubicin) for 1 year. Current chemotherapy recommendations for gastric carcinoma as well as the medical, psychosocial, and ethical considerations for chemotherapy treatment in the elderly are reviewed.