Gastric cancer is one of the most common upper gastrointestinal malignancies in China, with a significant proportion of patients diagnosed at advanced stages, leading to a poor clinical prognosis. Forkhead box O (FOXO) is a class of transcription factors widely present in eukaryotes, playing key roles in various physiological and pathological processes, including development, metabolism, and the occurrence and progression of malignant tumors. Clinical studies have demonstrated that FOXO is abnormally expressed in gastric cancer and is closely associated with its proliferation, migration, treatment response, and drug resistance. This article summarizes the regulatory mechanisms of FOXO, its role in the occurrence and progression of gastric cancer, and its potential as a therapeutic target for the disease.