A 73-year-old male was diagnosed as having a Borrmann type 4 gastric cancer with multiple liver metastases. Total gastrectomy (D2) with hepatic arterial cannulation was performed. Hepatic arterial infusion therapy of MTX (50 mg or 100 mg/body) and 5-FU (500 mg or 750 mg/body) was started postoperatively. A total dose of 1,150 mg of MTX and 6,250 mg of 5-FU caused a marked decrease in the volume of liver metastases and the effect remained for 8 months (partial response). Regarding drug concentrations, serum MTX levels rapidly decreased after bolus injection through hepatic artery and corresponded to those of intravenous injection as reported elsewhere. Serum 5-FU levels were maintained as low as 1.2 micrograms/ml during 2-hr continuous infusion and rapidly decreased after the end of the infusion. These results indicate that hepatic arterial infusion therapy of MTX and 5-FU may be safe and feasible for multiple liver metastases of Borrmann type 4 gastric cancer.