The value of adjuvant chemotherapy in T2N0 gastric cancer (GC) remains controversial. The aim of this retrospective study is to define a high-risk subgroup of pathological T2N0 GC patients and examine the impact of adjuvant chemotherapy on overall survival (OS). A total of 225 patients underwent R0 resection for T2N0 gastric adenocarcinoma between 2002 and 2012 and 51/225 (22.7%) of these received adjuvant chemotherapy. Multivariate Cox regression identified tumor location in the Upper1/3 of the stomach (peast one of the independent risk factor listed above, and we found that adjuvant chemotherapy significantly improved OS for this subgroup.