Gastric cancer is a significant global health issue, with over 1 million new cases diagnosed annually worldwide. Despite a decline in incidence and mortality over the past five decades, it remains the third leading cause of cancer-related deaths. The article reviews the epidemiology of gastric cancer, including incidence, mortality, survival, and secular trends, and discusses risk factors and prevention strategies. Gastric cancer incidence and mortality rates vary globally, with the highest rates observed in Eastern and South-Eastern Asia, and the lowest in North America and Africa. The lifetime risk of gastric cancer is about 1 in 54 for men and 1 in 126 for women. Chronic *Helicobacter pylori* infection is the primary risk factor, accounting for approximately 89% of distal gastric cancer cases. Other risk factors include tobacco smoking, low socioeconomic status, and a high-salt diet. Prevention efforts focus on screening and *H. pylori* eradication, with some countries implementing national screening programs. In the United States, gastric cancer incidence and mortality rates have been declining, but survival rates remain poor, especially for distant-stage disease. The article highlights the importance of understanding global and regional epidemiology to inform personalized risk stratification, screening, and prevention strategies.Gastric cancer is a significant global health issue, with over 1 million new cases diagnosed annually worldwide. Despite a decline in incidence and mortality over the past five decades, it remains the third leading cause of cancer-related deaths. The article reviews the epidemiology of gastric cancer, including incidence, mortality, survival, and secular trends, and discusses risk factors and prevention strategies. Gastric cancer incidence and mortality rates vary globally, with the highest rates observed in Eastern and South-Eastern Asia, and the lowest in North America and Africa. The lifetime risk of gastric cancer is about 1 in 54 for men and 1 in 126 for women. Chronic *Helicobacter pylori* infection is the primary risk factor, accounting for approximately 89% of distal gastric cancer cases. Other risk factors include tobacco smoking, low socioeconomic status, and a high-salt diet. Prevention efforts focus on screening and *H. pylori* eradication, with some countries implementing national screening programs. In the United States, gastric cancer incidence and mortality rates have been declining, but survival rates remain poor, especially for distant-stage disease. The article highlights the importance of understanding global and regional epidemiology to inform personalized risk stratification, screening, and prevention strategies.