OBJECTIVE: Determination of the postoperative morbidity and mortality after gastroenterostomy in patients with unresectable gastric cancer. STUDY DESIGN: Retrospective review of clinical records of all patients with obstructive distal gastric cancer who underwent gastroenterostomy at the Instituto de Enfermedades Neoplásicas between 1980 and 1993. The following factors were analyzed: age, sex, hemoglobin, albumin, preoperative risk, ascites, extent of disease, operative time, hospital stay, morbidity and mortality. RESULTS: 198 gastroenterostomy were done with a morbidity and mortality rates of 20% and 10%, respectively. Pneumonia was the principal cause of postoperative morbidity and mortality. High operative risk, adjacent organ invasion by the tumor and peritoneal metastasis were factors associated with increased postoperative morbidity (p > 0.05). High operative risk was the only prognostic factor for postoperative mortality (p < 0.01). CONCLUSIONS: Because of high postoperative morbidity and mortality, gastroenterostomy should not be done in patients with unresectable gastric cancer and high preoperative risk.