OBJECTIVE： To evaluate therapeutic efficacy and safety of chemotherapy combined with Xiaoaiping injection in the treatment of elderly patients with advanced gastric cancer. METHODS： 60 elderly patients with advanced gastric cancer were collected from our department during 2012-2014， and then divided into union group and single group with 30 cases in each group. Single group was given irinotecan （CPT-11） 150 mg/m2 added into 0.9％ Sodium Chloride injection， and union group was additionally given Xiaoaiping injection 80 ml， qd， on the basis of single group. A treatment course lasted for 14 days， and both groups received 4 courses of treatment. The tumor markers， disease single rate， progression-free survival （PFS） and the incidence of ADR were compared between 2 groups. RESULTS： After treatment， the levels of CEA， CA199 and CA242 in 2 groups were significantly lower than before； the union group was significantly lower than the single group， with statistical significance （P＜0.05）. The disease single rate of union group was 70.00％， which was significantly higher than that of single group （33.33％）. PFS of union group was （11.23±2.17） months， which was significantly longer that of single group [（9.36±0.84） months]， with statistical significance （P＜0.05）. The incidence of leucopenia， alanine aminotransferase elevation， diarrhea， stomatitis and hand-foot syndrome in union group was significantly lower than in single group， with statistical significance （P＜0.05）. CONCLUSIONS： Xiaoaiping injection combined with irinotecan chemotherapy for advanced gastric cancer has obvious effect with a low incidence of ADR.