OBJECTIVE： To observe the efficacy and safety of paclitaxel， oxaliplatin combined with elemene by peritoneal perfusion in the treatment of advanced gastric cancer with ascites. METHODS： 52 patients with advanced gastric cancer with ascites were randomly divided into control group （26 cases） and observation group （26 cases）. Patients in control group were in supine position， tube was placed in the abdominal cavity after peritoneal puncture， releasing ascites 1 000-1 500 ml， then Paclitaxel injection 120 mg/m2 was used by peritoneal perfusion， d1+Oxaliplatin for injection 85 mg/m2， d1. Patients in observation group were additionally given Elemene injection 0.5 g by peritoneal perfusion+2％ lidocaine hydrochloride injection 0.2 g. 14 d was a treatment cou- rse， patients were treated to death or a course of 1 year. Clinical efficacy， clinical benefit rate， 1-year survival rate， median survival time of death patients and the incidence of toxicities in 2 groups were observed. RESULTS： The total effective rate， clinical benefit rate and 1-year survival rate in observation group were significantly higher than control group， median survival time of death patients was significantly longer than control group， with statistical significance （P＜0.05）. And there was no significant difference in the incidence of toxicities in 2 groups （P＞0.05）. CONCLUSIONS： Paclitaxel， oxaliplatin combined with elemene by peritoneal perfusion has both good efficacy and safety in the treatment of advanced gastric cancer with ascites.