Objective:To investigate the efficacy and safety of anlotinib in the treatment of advanced gastric cancer.Methods:Eighty patients with advanced gastric cancer in Longhua District Central Hospital of Shenzhen City from February 2015 to May 2016 were selected. The patients were randomly divided into anlotinib group (anlotinib 12 mg) and placebo group by random number table method. The anlotinib or placebo was given once a day for two weeks and discontinued for one week, and three weeks were a course of treatment. The relief situation, total survival time as well as adverse reactions after treatment of all patients were compared between the two groups.Results:The remission rate in the anlotinib group was higher than that in the placebo group [61.6% (37/60) vs. 5.0% (1/20)], and the difference was statistically significant ( χ2 = 19.315, P < 0.05). The overall survival time of the anlotinib group was longer than that of the placebo group [(22.8±1.0) months vs. (10.3±0.9) months], and the difference was statistically significant ( P < 0.01). The adverse reactions mainly included hypertension, diarrhea, nausea and vomiting, liver damage, etc. The adverse reactions were mild, and no drug-related deaths occurred. There was no statistically significant difference in the incidence of adverse reactions between the two groups (all P > 0.05). Conclusion:Anlotinib is effective and safe in the treatment of advanced gastric cancer.