We report a case of gastric small cell carcinoma with metastatic liver tumors responding to surgery and chemotherapy. The patient was a 67-year-old man with advanced gastric cancer, clinically diagnosed as P0H1M0CY0T3N1. He was registered in a phase III trial, and was scheduled to undergo gastrectomy and S-1 plus CDDP chemotherapy after surgery. He underwent D1 total gastrectomy and Roux-en-Y reconstruction. Small cell carcinoma of the stomach was diagnosed from the histopathological findings. After surgery, he received the following chemotherapy: 13 courses of CPT-11 plus CDDP chemotherapy, 2 courses of S-1, 5 courses of paclitaxel, and 6 courses of CPT-11. The patient is alive 22 months after his operation. We conclude that the combination of surgery and chemotherapy was effective for small cell carcinoma of the stomach, which was considered to have a poor prognosis.