Objective: To analyze the survival and prognostic factors in T4 gastric cancer patients after radical resection. Methods: Retrospective analysis was conducted in 183 T4 gastric cancer patients with complete clinical and follow-up data, who underwent radical resection from January 2007 to December 2011. Results: In the entire group of patients, the 1-, 3- and 5-year cumulative survival rate was 92%, 60% and 42%, respectively. Univariate analysis showed that the metastatic lymph node ratio, pN stage, depth of invasion and histological type were significantly associated with the survival of the patients (all P<0.05). Multivariate analysis revealed that the metastatic lymph node ratio, pN stage, and depth of invasion were the independent risk factors for the prognosis of the patients (all P<0.05). Conclusion: Metastatic lymph node ratio, pN stage and depth of invasion are important factors affecting the postoperative survival of T4 gastric cancer patients undergoing radical resection.