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AIM: To investigate the relation between RECK methylation and clinicopathological characteristics of gastric cancer patients and evaluate the role of RECK methylation in peritoneal metastasis of gastric cancer.METHODS: Methylation of RECK gene in 40 paired samples of gastric cancer and its corresponding adjacent normal mucosa, lymph nodes and peritoneal irrigation fluid was detected by methylation-specific polymerase chain reaction.RESULTS: Aberrant methylation of RECK gene was detected in 27.5% (11/40) of the adjacent normal mucosa samples, in 47.5% (19/40) of gastric cancer samples, in 57.1% (12/21) of the lymph node samples,and in 35% (14/40) of peritoneal irrigation fluid samples,respectively, with a significant difference between the adjacent normal mucosa and lymph node samples ( P=0.023). Presence of RECK methylation in the primary tumor samples was significantly correlated with tumor invasion ( P=0.023). The accuracy of RECK methylation in peritoneal lavage fluid samples for the diagnosis of peritoneal metastasis of gastric cancer was 72.5% (26/40), with a sensitivity of 66.7% (6/9) and a specificity of 74.2% (23/31).CONCLUSION: Aberrant methylation of RECK gene may provide useful information for the early diagnosis and treatment of peritoneal metastasis of gastric cancer.