Objective: To evaluate the feasibility and efficacy of laparoscopy-assisted radical gastrectomy for elderly obese patients with gastric cancer. Methods: Retrospective study was conducted in the clinical data of 26 obese elderly patients (obese group) undergoing laparoscopy-assisted radical gastrectomy from September 2008 to September 2012, and 67 non-obese elderly patients (non-obese group) who underwent laparoscopy-assisted radical gastrectomy during the same period. Results: The operative time in obese group was significantly longer than that in non-obese group [(231.2±51.4) min vs. (208.5±53.6) min, P=0.039], but no statistical differences were observed between the two groups in terms of intraoperative blood loss or length of postoperative hospital stay (both P>0.05). The incidences of postoperative complications between the two groups showed no significant difference (23.1% vs. 22.4%, P=0.589), and all the immunological parameters on postoperative day 1, 3 and 5 between the two groups showed no significant difference (all P>0.05). The score of postoperative physical condition in obese group was higher than that in non-obese group (P<0.05), while the scores of postoperative dyspnea and fatigue in obese group were lower than those in non-obese group (both P<0.05), but all other scores for assessment of quality of life had no significant difference between the two groups (all P>0.05). Eighty-eight patients (90.3%) were followed up for 2-48 months.. The 1-, 2- and 4-year survival rate in obese group was 91.3%, 78.2% and 65.2% , and in non-obese group was 93.4%, 77.7% and 62.3% respectively, which had no statistical difference between the two groups (χ2=0.011, P=0.916). Conclusion: Obesity may cause a prolonged operative time for laparoscopic radical gastrectomy in elderly patients, but may not influence operative safety and short-term efficacy.