Objective To study the application value of endoscopic ultrasonography (EUS) and multi-slice spiral CT (MSCT) in preoperative staging of gastric cancer. Methods Seventy-nine patients with gastric cancer confirmed by biopsy in our hospital between September 2012 and September 2014 were examined by EUS and MSCT, and the results were compared with the postoperative pathological findings. Results The accuracy of EUS in the diagnosis of T staging of gastric cancer (89.87%) was significantly higher than that of MSCT (P<0.05). The accuracy of EUS in the diagnosis of T3 stage(90.91%) was higher than that of MSCT (63.64%) (P<0.05). The accuracy of MSCT in the diagnosis of M stage of gastric cancer (79.75%) was significantly higher than that of EUS (65.82%) (P<0.05). Conclusion The accuracy rates of both EUS and MSCT in the diagnosis of stage of gastric cancer are high. The accuracy of MSCT in the diagnosis gastric cancer T stage is higher while the accuracy of MSCT in the diagnosis of gastric cancer M stage is higher. The combined diagnosis of both methods is of guiding significance in choosing treatment regimen of gastric cancer.