Management of gastric cancer with malignant ascites is a challenge, and limited data are available. We evaluated factors affecting survival for this condition to determine factors that predict survival outcome and to develop a rational treatment plan. We retrospectively studied 5,542 patients with gastric adenocarcinoma from January 2007 to December 2012. Among them, 347 patients (6.26 %) were associated with malignant ascites. The patients’ overall survival was compared among the different features. Three hundred forty-seven patients (153 females and 194 males; median age, 53 years) were enrolled, including 78 (22.5 %) young patients and 63 (18.1 %) elderly patients. One hundred forty-three (41.2 %) patients presented with malignant ascites at the initial diagnosis of gastric cancer, and 211 (60.8 %) received chemotherapy. After a median follow-up duration of 10.4 months, the median survival after the diagnosis of malignant ascites was 5.2 months (95 % CI, 4.8–5.6 months), and the 1-year survival rate was 16.1 %. An ECOG score greater than 2 (P