Abstract: OBJECTIVE To systematically evaluate the rationality of tegafur-gimeracil-oteracil potassium in the treatment of gastric cancer. METHODS Check the latest edition of medicine instruction, the authority of the drug guide and rules of diagnosis and treatment, so as to collect all the indications of tegafur-gimeracil-oteracil potassium. Micromedex, GIN, NGC, PubMed, Dynamed, Uptodate, CBM, CNKI, Epistemonikos, Embase, Cochrane Library and Wanfang database were searched from database foundation to 2020 January 10. Research literatures of tegafur-gimeracil-oteracil potassium in the treatment of gastric cancer were collected and the efficacy and safety of the drug for the treatment of gastric cancer were evaluated systematically. RESULTS Tegafur-gimeracil-oteracil potassium mentioned in the FDA's instructions for the treatment of advanced gastric cancer combined with cisplatin, and NMPA's instructions for the treatment of unresectable local advanced or metastatic gastric cancer. There were 5 guidelines and 8 systematic reviews in the query database, which focused on the efficacy and safety of tegio in the treatment of gastric cancer. According to the AGREE II score of the guidelines, 2 of the 5 included guidelines mentioned the level of evidence and the level of recommendation had high quality, and recommended that tegafur-gimeracil-oteracil potassium be used for adjuvant treatment after D2 gastric cancer resection; 3 were of low quality, only mentioned that tegafur-gimeracil-oteracil potassium could be used for adjuvant chemotherapy of gastric cancer. According to AMSTAR score, the overall quality of the 8 systematic evaluations was moderate, but according to GRADE tool method, the evidence grade of the outcome index of the included systematically evaluation was scored, and the result showed that the overall evidence grade was not high. CONCLUSION Tegafur-gimeracil-oteracil potassium can be recommended as an adjuvant treatment for gastric cancer after D2 dissection. In patients with advanced gastric cancer, tegafur-gimeracil-oteracil potassium is as effective as other gastric cancer drugs. What's more, chemotherapy-related malignant, vomiting, anorexia, and other gastrointestinal reactions are mild, and the risk of bone marrow suppression is low. It is recommended that the combination regimen containing tegafur-gimeracil-oteracil potassium is given priority in chemotherapy for advanced gastric cancer.