Objective. To evaluate the efficacy of laparoscopy and laparotomy after neoadjuvant chemotherapy in the treatment of advanced gastric cancer by meta-analysis. Methods. Cochrane Library, Embase, and PubMed were searched by computer until December 1, 2021. Literature was screened according to inclusion and exclusion criteria, and relevant data were extracted for meta-analysis using RevMan 5.3. Results. A total of 1027 patients from 11 literature studies were included in this study, including 413 patients in the laparoscopic group and 614 patients in the open group. Meta-analysis showed that the laparoscopic group had less intraoperative bleeding (SMD = −1.11; 95% CI: −1.75–0.47;
P
=
0.0006
), early postoperative exhaust (SMD = −0.45; 95% CI: −0.70–0.20;
P
=
0.0004
), and shorter postoperative hospital stay (SMD = 0.97; 95% CI: 1.69∼0.26;
P
=
0.008
), but had longer the operation time (SMD = 0.65; 95% CI: 0.52∼0.79;
P
<
0.00001
). There was no significant difference in the number of lymph nodes dissected during operation (SMD = −0.45; 95% CI: −0.42–0.19;
P
=
0.45
), the incidence of surgical complications 30 days after operation (OR = 0.78; 95% CI: 0.53∼1.13;
P
=
0.19
), time of first defecation (MD = 0.00; 95% CI: −0.10∼0.10;
P
=
0.98
), and time of first postoperative feeding (MD = −0.05; 95% CI: −0.22∼0.12;
P
=
0.54
) between the two groups. For long-term prognosis, there was no significant difference in the 3-year overall survival rate after operation between the two groups (RR = 0.84; 95% CI: 0.63–1.12;
P
=
0.23
). Conclusion. Compared with the open stomach cancer surgery, laparoscopic gastric cancer surgery has less intraoperative blood loss, shorter hospitalization time, and advantages such as early rehabilitation, postoperative complications rate, and long-term survival, which confirmed the validity and security of the laparoscopic surgery.