Objective To investigate the possible contributing risk factors, diagnosis and treatment of gastroparesis after abdominal surgery. Methods Potential risk factors, clinical manifestations and therapeutic approaches of 22 cases of gastroparesis after abdominal operation were analyzed retrospectively. Results In this series, gastroparesis more frequently occured in those patients having a long-term preoperative gastric outlet obstruction, malignant tumor, O type blood group pancreaticoduodenectomy or simple gastrojejunostomy without gastric resection. Endoscopy, upper gastrointestinal radiography and radioisotope scintigraphy were effective methods in the diagnosis of gastroparesis, and normal gastrointestinal movement was achieved mostly in 5 weeks postoperatively by conservative treatments.Conclusions Postoperative gastroparesis can recover spontaneously after a longer period of supportive treatment combined with prokinetic drugs, and reoperation should be avoided.