There is a close relationship between intra-abdominal adipose tissue distribution and early outcomes of gastrectomy with D2 lymph node dissection for gastric cancer. However, the common body surface measurement related to obesity can not accurately reveal the intra-abdominal adipose tissue distribution. The newly-developed multidetector-row computed tomography (MDCT) can quantitatively measure the adipose tissue distribution. The effects of adipose tissue distribution evaluated by MDCT before operation on early surgical outcomes of gastric cancer are reviewed in this paper.