Gastric cancer (GC) is one of the most common disease and fifth most common cancer among male and seventh most common cancer among female in India. It is the most frequent causes of majority of deaths among non-communicable diseases in the world.The incidence of GC is higher in developed Asian countries like Republic of Korea, China, India and Japan. This review summarizes the newer concepts of microbial etiopathogenesis and molecular or recent diagnostic tools of GC and the new important recommendations for the management of patient with GC.The etiological factors and pathogenesis of GC are not yet fully understood but it is affected by several other factors like; strain diversity, genetics, environmental, immunological response of host, exposure to N-nitroso compounds from diet or smoking, alcohol, low socioeconomic status, BMI, age, previous gastric surgery and geographical distribution. To understand the pathogenesis of GC, several researchers mentioned the incidence, etiology, diagnostic tools and the different therapeutic options have also undergone important changes in recent years. Helicobacter pylori is a well recognized risk factor, which can modulate the acidity of the stomach to alter the gastric microbiome, causing H. pylori-associated diseases. Moreover, there is increasing evidence that bacteria other than H. pylori and their metabolites also contribute to gastric carcinogenesis. Therefore, the development and progression of GC can lead to improvements in prevention, diagnosis, and treatment. In this review, we discuss the carcinogenic effects of H. pylori and non-H. pylori microorganism in GC, as well as the potential therapeutic role for GC.