We report three patients who were successfully treated with orthopedic surgery for spinal paralysis due to spine metastasis of gastric cancer. Case 1: A 75-year-old female had lower limb paralysis due to metastasis of Th1-Th3 one year and four months after total gastrectomy for gastric cancer. Although radiotherapy was carried out from the day following a paralysis appearance, the paralysis deteriorated from D to C. Then, when direct decompressive surgical resection had been performed eight days after the paralysis appearance, the paralysis improved from C to D. Case 2: A 50-year-old male had lower limb paralysis due to metastasis of Th2 three years and eight months after distal gastrectomy for gastric cancer. Paralysis had improved from C to D with direct decompressive surgical resection three days after the paralysis appearance and radiotherapy after surgery. Case 3: An 80-year-old male had lower limb paralysis due to metastasis of Th3 five years and eight months after total gastrectomy for gastric cancer. Paralysis had improved from B of a Frankel classification to C with direct decompressive surgical resection seven hours after the paralysis appearance and radiotherapy after surgery. When the spinal paralysis due to spine metastasis of gastric cancer appeared, the orthopedic surgery for QOL maintenance was considered to be one of the useful medical treatment options.