Currently, chemotherapy combined with immune checkpoint inhibitors (ICIs) has become one of the important treatments for advanced gastric cancer or adenocarcinoma of esophagogastric junction. However, the effectiveness of this approach in locally advanced gastric cancer has still not been validated by higher-level studies. The combination of molecular markers and personalised tests may be an effective means of screening the population for the benefits of immunotherapy in gastric cancer; The neoadjuvant immunotherapy regimen should take into account the specific type of tumour, molecular characteristics, and the patient’s overall health status. Routine evaluation after 2-4 cycles of neoadjuvant therapy combined with multidisciplinary team  discussion can grasp the best timing during the whole treatment process and maintain the best interests of patients; The evaluation of the efficacy of neoadjuvant immunotherapy requires comprehensive judgment, and imaging and pathological evaluation are still subject to great controversy; The surgical interval of 4-6 weeks after neoadjuvant immunotherapy may be the optimal timing of surgery. The choice of surgery should take into account the location and size of the tumour, the patient's overall health status, and technical feasibility. Careful management and effective intervention of adverse events (IrAEs) during neoadjuvant immunotherapy will help to improve the patient’s outcome, and clinicians should closely monitor the patient’s physical response throughout the course of the treatment and adjust the treatment regimen accordingly to ensure the best-balanced outcome.