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<p>Abstract</p> <p>Background</p> <p>Results from large epidemiologic studies on the association between vitamin D and gastric cancer are controversial. Vitamin D significantly promotes apoptosis in the undifferentiated gastric cancer cell, but the prognostic effects of its levels are unknown.</p> <p>Methods</p> <p>197 gastric carcinoma patients who received treatment in the cancer centre of Sun Yat-sen University from January 2002 to January 2006 were involved in the study. The stored blood drawn before any treatment was assayed for 25-hydroxyvitamin D levels. The clinicopathologic data were collected to examine the prognostic effects of vitamin D.</p> <p>Results</p> <p>The mean vitamin D levels of the 197 gastric patients was 49.85 ± 23.68 nmol/L, among whom 114(57.9%) were deficient in Vitamin D(< 50 nmol/L), 67(34%) were insufficient (50-75 nmol/L) and 16(8.1%) were sufficient (> 75 nmol/L). Clinical stage (<it>P </it>= 0.004) and lymph node metastasis classification (<it>P </it>= 0.009) were inversely associated with vitamin D levels. The patients with high vitamin D levels group (≥ 50 nmol/L) had a higher overall survival compared with the low vitamin D levels group (< 50 nmol/L)(<it>P </it>= 0.018). Multivariate analysis indicated that vitamin D levels were an independent prognostic factor of gastric cancer (<it>P </it>= 0.019).</p> <p>Conclusions</p> <p>Vitamin D deficiency may be associated with poor prognosis in gastric cancer.</p>