Perioperative chemotherapy provides advantage for gastric cancer patients in terms of survival. A 56-year male with a diagnosis of locally advanced gastric carcinoma presented with complaints of acute abdominal pain; and was diagnosed as gastric tumor perforation during neoadjuvant therapy. Gastric perforation may occur during neoadjuvant chemotherapy for gastric cancer. While the treatment of choice for these perforations was surgery in the past, it is now shifting towards a minimally invasive or non-invasive approach. We used the minimally invasive treatment approach with nasogastric drainage, intravenous antibiotics and proton pump inhibitors, which was effective in the treatment of perforation. Althrough, conservative treatment approach may be an effective management option in selected patients with gastric cancer perforation. Key Words: Gastric cancer, Neoadjuvant chemotherapy, Perforation.