Background: In the United States, gastric cancer is a relatively uncommon tumor. Overall surgical experience with minimally invasive surgery (MIS) has increased, however published reports on laparoscopic resection of gastric cancer are mostly limited to small, single institution experiences. Methods: Between 2000 and 2012, 880 patients who underwent surgical resection of a gastric cancer were identified from a multi-center database. Clinicopathological characteristics, receipt of peri-operative therapy, operative details, and oncologic outcomes were analyzed and defined. Results: Median patient age was 65.8 years and 42.6% (375/880) were female. Median tumor size at diagnosis was 4.0 cm (2.5-6.8 cm). A minority of patients received neoadjuvant therapy (207, 32.7%). Overall, 70 (8%) patients had a minimally invasive (MIS) approach: laparoscopic (60, 85.7%) and laparoscopic hand assist (10, 14.3%). Patients who underwent MIS resections were more likely to a smaller tumor (MIS: 3.0 cm vs. open: 4.5 cm) (p<0.001). MIS resections were associated with similar estimated blood loss (MIS: 150 cc vs. open: 250 cc, p=0.14) and similar operative time (MIS: 271 min vs. open: 232 min, p=0.07) compare to open surgery. An R0 resection was achieved in the overwhelming majority of patients (MIS: 98.6% vs. open: 90.9%; p=0.03). Post-operatively, MIS patients had a similar incidence of complications (MIS: 20% vs. open: 33.1%, p=0.07) and a similar length of stay (MIS: 7 d vs. open: 9 d, p=0.13) compare to open surgery patients. For the entire cohort, median recurrence-free survival was 27.34 months and median overall survival was 33.42 months. In analyzing the entire cohort, the overall 5-year survival of patients treated with MIS was 42.6% vs. 35.8% for patients treated with an open approach (p=0.05). In the propensity score-matched multivariate model, laparoscopy remained associated with an improved long-term overall (HR 0.34) survival (P<0.001). Conclusions: An MIS approach to select patients with gastric cancer is associated with a high R0 resection rate. The long-term oncological outcome following MIS is excellent and therefore the MIS approach should be considered.