The prevention and treatment of gastric cancer in China confront multifaceted challenges, including high incidence rates, substantial disease burden and suboptimal management system.Establishing a precision gastric cancer control infrastructure with integrated “prevention, diagnosis and treatment” strategies has become an urgent public health priority. In terms of disease prevention, evidence-based eradication therapy of Helicobacter pylori has demonstrated remarkable clinical advances. Novel endoscopic diagnostic technologies for precancerous lesions are under clinical translation, which accurately identify conditions such as high-risk intestinal metaplasia. Regarding innovative diagnostic technologies, cutting-edge endoscopic molecular imaging and liquid biopsy can significantly increase early detection rates of gastric cancer. In regard to treatment modalities, comprehensive clinical benefits have been achieved, largely through advances in immunotherapy, targeted therapy, radiotherapy, as well as treatment personalization based on cancer molecular subtyping. Moreover, high-throughput multi-omics sequencing is currently integrated with artificial intelligence technology. These pioneering technologies are projected to expedite resolution of pivotal scientific challenges in gastric cancer management, catalyzing transformative progress across basic-clinical research domains, driving China’s gastric cancer control paradigm shift from empirical medicine to precision frameworks, ultimately achieving the public health dual-goal of incidence and mortality rates in the near future.