We report a case of advanced gastric carcinoma successfully treated with a combination of irinotecan and cisplatin as neoadjuvant chemotherapy. The patient, a 51-year-old woman, had a type 2 gastric carcinoma, which had metastasized to paraaortic lymph nodes. She was treated with irinotecan, 70 mg on day 1 and day 15, and cisplatin, 80 mg on day 1. The course was repeated every 4 weeks. Two courses of treatment resulted in a marked reduction of both the primary tumor and lymph nodes. Subsequently, the patient underwent curative surgery consisting of pancreatoduodenectomy and D3 lymph node dissection. No surgical complication was observed. On microscopic examination, only a few tumor cells were detected in the granulation tissues of the lymph nodes, but viable cancer cells still remained in the resected stomach. This patient has been free of disease for more than 10 years after operation. This case demonstrates the effectiveness and safety of irinotecan and cisplatin used in an neoadjuvant setting for treatment of advanced gastric carcinoma.