Background and Aims Gastric squamous cell carcinoma (GSCC) is a rare malignant tumor of the stomach. There is a lack of large-scale clinical data studies on this patient population, and the prognostic value of surgical treatment remains unclear. Therefore, this study was conducted to investigate the impact of surgical treatment on the prognosis of GSCC patients.Methods The clinical data of GSCC patients pathologically diagnosed between 2000 and 2019 were extracted from the SEER database. The impact of surgical treatment on the overall survival (OS) and cancer-specific survival (CSS) of GSCC patients were analyzed, and the influencing factors for OS and CSS, as well as the value of surgical treatment for GSCC patients with different clinicopathologic characteristics, were determined.Results A total of 334 GSCC patients were included, among whom 83 (24.85%) underwent surgical treatment, while 251 (75.15%) did not. After 1:1 propensity score matching to balance baseline data, each group consisted of 81 patients. Survival analysis showed that the 5-year OS rate (32.07% vs. 11.08%, χ²=20.30, P<0.001) and CSS rate (41.93% vs. 18.45%, χ²=17.10, P<0.001) in the surgery group were significantly better than those in the non-surgery group. Cox multivariate analysis indicated that marital status, pathological differentiation, SEER stage, surgical treatment, and radiotherapy were independent factors for OS and CSS in GSCC patients (all P<0.05). Further stratified analysis based on clinicopathologic characteristics showed that the OS was significantly improved in those married (HR=0.42, 95% CI=0.251-0.70, P=0.001), with highly differentiated tumor (HR=0.09, 95% CI =0.01-0.84, P=0.035), with localized tumor (HR=0.33, 95% CI=0.17-0.65, P=0.001), and receiving radiotherapy (HR=0.35, 95% CI=0.21-0.58, P<0.001) who underwent surgery. Similarly, CSS was significantly improved in those married (HR=0.44, 95% CI=0.25-0.78, P=0.005), with highly differentiated tumor (HR=0.09, 95% CI=0.01-0.84, P=0.035), with localized tumor (HR=0.34, 95% CI=0.15-0.75, P=0.007), and receiving radiotherapy (HR=0.31, 95% CI=0.18-0.55, P<0.001) who underwent surgery.Conclusion Surgical treatment can effectively improve the prognosis of GSCC patients. Particularly, those who are married, have highly differentiated tumors and localized tumors, and receive radiotherapy are the best beneficiaries of surgical treatment.