OBJECTIVE To observe the ther apeutic efficacy and safety of albumin-bound paclitaxel combined with oxaliplatin in the first-line treatment of advanced gastric cancer （GC）. METHODS A total of 90 advanced unresectable GC patients were randomized into observation group and control group ，with 45 patients in each group. Control group was given oxaliplatin combined with tegafur ，and observation group was given albumin-bound paclitaxel combined with oxaliplatin. A chemotherapy cycle last for 21 days，and both groups received 6 cycles of chemotherapy ，and then the follow-up observation was conducted every 2 weeks. Short-term efficacy （after 2 chemotherapy cycles ），mid-term efficacy （after 6 chemotherapy cycles ），tumor marker，long-term efficacy （after follow-up ），quality of life ，the occurrence of ADRs were compared between 2 groups. RESULTS After 2 cycles of treatment ，objective remission rate （ORR）of observation group was significantly higher than that of control group （60.00％ vs. 37.78％，P＜0.05）；there was no statistical significance in disease control rate between the two groups （P＞0.05）. After 6 chemotherapy cycles ，ORR of observation group was significantly higher than that of control group （55.56％ vs. 31.11％，P＜0.05）；there was no statistical significance in disease control rate between the two groups （P＞0.05）；the levels of tumor markers [carcinoembryonic antigen ， carbohydrate antigen （CA）724， CA199， CA242] in observation group were significantly lower than those of control group （P＜0.05）. After the follow-up period ，the median progression-free survival [ 8.78 （95％CI：6.94-11.01）months] and the median overall survival [ 13.02（95％CI：12.78-15.62）months] of observation group were significantly longer than those [ 6.99（95％CI：3.67-10.88）months and 10.42（95％CI：8.72-13.22）months] of control group （P＜ 0.05）. The score of body dimension in the observation group was significantly higher than that in the control group （P＜0.05）. Except for peripheral neurotoxicity ，there was no significant difference in the incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS Albumin-bound paclitaxel combined with oxaliplatin has a good effect and safety in the first-line treatment of advanced unresectable GC.