OBJECTIVES: Gastric cancer is the third leading cause of cancer death in both sexes worldwide. Almost one million new cases were estimated to have occurred in 2012 in the world. In Italy the estimated new cases of cancer were 13,987 and the estimated deaths were 9,247 in 2015. Currently, the management processes of patients with gastric cancer have largely remained unexamined. The main objective of the study is to design an optimized Patient Diagnostic Therapeutic Pathwayfor the Veneto Region (Italy) characterized by high quality of care and high levels of organizational and economic efficiency. METHODS: Analysis of the scientific literature and national clinical guidelines of gastric cancer. A questionnaire was designed to collect data and information regarding both the organizational structure of the 5 Centres and the different phases of patients pathways. Conduction of 36 interviews with the healthcare professionals. Realization of 5 flow charts representing the patients pathways, from the diagnosis phase to the follow up phase. RESULTS: The organizational analysis of pathways shows many differences mainly between two Hub Centres and three Spoke Centres. An Hub Centre, in particular, has a larger group of healthcare professionals dedicated to the pathology including a psychologist and a nutritionist. Furthermore, the Centre has a programme of “Simultaneous Palliative Cure” to support the patients in the advanced stage of the disease. The analysis of the five flow-chart allowed the identification of an optimized pathway for the patient with gastric cancer. CONCLUSIONS: The study identified an optimized pathway - able to engage all healthcare professionals involved in the care and management of the patient - to be adopted at the regional level for a more effective, more integrated and efficient management of patients affected by gastric cancer.