Background: The FLOT4-AIO trial demonstrated a survival benefit in patients with resectable gastric or GOJ adenocarcinoma who received FLOT compared to ECX/ECF (epirubicin, cisplatin, capecitabine or fluorouracil) chemotherapy, but there has been no direct comparison made between FLOT and EOX/EOF regimens in randomised trials to date. Methods: Patients with locally advanced, resectable gastric or GOJ adenocarcinoma treated between December 2012 to December 2019 with FLOT or EOX/EOF in the Midland region were identified. FLOT patients received four preoperative and four postoperative 2-week cycles of 50 mg/m2 docetaxel, 85 mg/m2 oxaliplatin, 200 mg/m2 leucovorin and 2600 mg/m2 fluorouracil as 24-h infusion on day 1. The EOX/EOF patients received three preoperative and three postoperative 3-week cycles of 50 mg/m2 epirubicin, 130 mg/m2 oxaliplatin on day 1 plus either 200 mg/m2 fluorouracil as continuous intravenous infusion or 1250 mg/m2 capecitabine orally on days 1 to 21. We compared the pathological response and tolerability of these regimens. Results: 38 patients received FLOT and 36 patients received EOX/EOF chemotherapy. The median age was 60 and 63.5 respectively. R0 resection was achieved in 31 out of 35 FLOT patients (89%), and 32 out of 35 EOX/EOF patients (91%) who proceeded with surgical resection following pre-operative chemotherapy. AJCC tumour regression score 0-1 was seen in 14 (37%) FLOT patients and 12 (33%) EOX/EOF patients. 30 (79%) FLOT patients and 29 (80%) EOX/EOF patients completed their planned preoperative courses. In the postoperative phase, 20 (56%) FLOT patients and 9 (25%) EOX/EOF patients completed their planned course. Dose reductions occurred in 27% of FLOT patients and 15% of EOX/EOF patients. Grade 3/4 adverse events occurred in 30% of FLOT cycles, and 19% of EOX/EOF cycles administered. Conclusions: Perioperative FLOT and EOX/EOF chemotherapy had similar pathological response, with higher completion of postoperative chemotherapy with FLOT regime.