Background: This study evaluated the efficacy of percutaneous radiofrequency ablation (RFA) for the treatment of metachronous liver metastases of gastric cancer. Methods: We enrolled a total of 44 patients who underwent RFA for the treatment of metachronous liver metastases after resection of a primary gastric adenocarcinoma from January 2002 to November 2011. The primary endpoint of this study was overall survival (OS) and recurrence-free survival (RFS) after RFA. Results: Systemic chemotherapy was combined with RFA in 40 patients.The OS and RFS after RFA for all patients were 14.7 (95% CI, 10.1-19.2) and 6.1 months (95%, CI 4.2-8.1). the OS and RFS of the patients with liver-only metastasis who underwent RFA and chemotherapy were 20.9 months (95% CI 18.4-23.4) and 9.8 months (95% CI 9.2-10.5), respectively. On multivariate analysis, the factors independently, negatively associated with RFS were bilobar intrahepatic distribution (HR 3.9, 95% CI 1.5-9.9, p=0.001), and extrahepatic metastatic lesions (HR 3.6, 95% CI 1.6-7.8, p=0.003). The factors independently, negatively associated with OS were extrahepatic metastatic lesions (HR 12.6, 95% CI 3.7-42.9, p=0.001), no chemotherapy (HR 43.3, 95% CI 7.4-251.3, p=0.001), and tumor number (≥ 2) (HR 2.6, 95% CI 1.2-5.9, p=0.015). Conclusions: The efficacy of RFA for metachronous liver metastases of gastric cancer is limited to patients with a single, unilobar metastasis without extrahepatic metastatic lesions. Combined systemic chemotherapy is very important for the prolongation of overall survival.