A 66-year-old man was diagnosed with unresectable distal gastric cancer due to a locally advanced tumor and peritoneal dissemination. After gastrojejunostomy, he underwent S-1 plus cisplatin combination chemotherapy. After 2 courses of chemotherapy, weekly paclitaxel(PTX)was administered as second-line chemotherapy owing to tumor growth(PD). Although 4 courses of chemotherapy had been administered, he developed carcinomatous peritonitis and was hospitalized urgently. Despite diuretic therapy and drainage, the malignant ascites was not adequately controlled. However, he started ramucirumab (RAM)plus PTX chemotherapy as third-line therapy and ascites subsequently reduced, he regained oral intake and was discharged from hospital.