OBJECTIVES: Gastric cancer (GC) imposes a significant burden of disease globally. Multiple treatments are available but are associated with high costs and potentially detrimental effects on quality of life. The utility values of health status are measures of patient preference over quality of life, which are increasingly used for health and economic decision-making. Currently, there is little systematized information on the utility values for different stages of GC. This systematic review synthesizes and meta-analyses the literature on GC utilities. METHODS: A search was conducted in PubMed, Embase, MEDLINE, and Cochrane Library for studies reporting utility values calculated using direct and indirect methods. Information from the selected studies was extracted and appraised, and meta-analyses of utility values based on GC health states were performed. RESULTS: Twelve studies involving 4585 patients were included. Random-effects meta-analysis estimates showed a mean utility of 0.77 (95% CI 0.7-0.85) for stage I, 0.75 (95% CI 0.65-0.85) for stage II, 0.70 (95% CI 0.63-0.96) for stage III, and 0.64 (95% CI 0.56-0.32) for stage IV. All estimates showed considerable heterogeneity. CONCLUSIONS: Our study provides an updated overview of the literature on utility values in GC and presents a discussion of the relevance of GC stages for its analysis. Decision-makers should consider patients' preferences in the proposal of policies and clinical decisions.