Abstract: OBJECTIVE To investigate the effects of apatinib combined with SOX regimen on the efficacy, blood routine, serum hypoxia inducible factor 1α(HIF-1α) and vascular endothelial growth factor(VEGF) levels in patients with advanced gastric cancer. METHODS Prospectively selected 96 patients with advanced gastric cancer who were diagnosed and treated in Inner Mongolia Baogang Hospital, from January 2018 to January 2019 as the research objects, and they were simply randomly divided into two groups using a random number table method. The control group(48 cases) was treated with SOX regimen. The observation group(48 cases) was treated with apatinib on the basis of the control group. The 21 d was 1 cycle, and both were treated for 2 cycles. The efficacy, blood routine, serum HIF-1α and VEGF levels before and after treatment, and the occurrence of adverse reactions during treatment of the two groups were compared. RESULTS The average and median of disease progression-free survival time and overall survival time of the observation group were higher than those of the control group(P<0.05). Repeated measurement analysis of variance showed that the time point effect, treatment method, time point and treatment method interaction effects could all significantly change the levels of white blood cells, hemoglobin, platelets, HIF-1α, and VEGF(P<0.05); and the levels of white blood cells, hemoglobin, platelets, HIF-1α and VEGF after treatment in observation group were significantly lower than those in the control group(P<0.05). The observation group had no statistically significant differences in the incidence of Ⅰ-Ⅳ and Ⅲ-Ⅳ hypertension, oral ulcers, fatigue, hand-foot skin reactions, neurotoxicity, leukopenia, and thrombocytopenia during drugs treatment in the observation group. CONCLUSION Apatinib combined with SOX chemotherapy regimen for advanced gastric cancer can significantly prolong survival and reduce serum HIF-1α and VEGF levels with a higher safety profile, but it has a certain impact on platelets, white blood cells, hemoglobin and other routine blood indicators.