Abstract: Objective To analyze the trend of gastric cancer incidence in registered residents in Wenzhou of Zhejiang Province from 2014 to 2023 and provide the scientific basis for gastric cancer prevention and control. Methods The data of gastric cancer that met the requirements were collected and analyzed through the Wenzhou Chronic Disease Monitoring and Management information System from 2014 to 2023. The registration covered all counties (cities and districts) and all registered residents in Wenzhou City and was grouped by gender and age. The crude incidence rate, age-standardized incidence rates by China age-standardized rate (ASRC) and by world age-standardized rate (ASRW), truncated age-standardized incidence rate (35-64 years) and cumulative rate (0-74 years old) were calculated. The average annual percentage change (AAPC) was used to analyze the incidence of gastric cancer. Results From 2014 to 2023, the crude incidence rate of gastric cancer in Wenzhou was 34.13/10⁵, ranking the 4^th in the incidence sequence of malignant tumors. There was no changing trend over the years (AAPC=-0.327%, P>0.05). The ASRC and ASRW of gastric cancer were 20.16/10⁵ and 19.80/10⁵, respectively, both showing a downward trend (AAPC= -3.227%, -3.235%, P <0.05). The truncated age-standardized incidence rate (35-64 years) was 26.40/10⁵ and the cumulative rate (0-74 years old) was 5.61%. The crude incidence rate, ASRC, ASRW, truncated age-standardized incidence rate (35-64 years) and cumulative rate (0-74 years old) of gastric cancer in men were all higher than those in women. From 2014 to 2023, the crude incidence rates of gastric cancer in both men and women did not show a time-varying trend (both P> 0.05), while the ASRC and ASRW showed a downward trend (for men: AAPC=-3.427%, -3.496%, both P<0.05; for women: AAPC=-2.184%, -2.099%, both P<0.05). The age-specific incidence rate of gastric cancer showed an upward trend with the increase of age. The crude incidence rate of gastric cancer increased significantly after the age of 45 and reached a peak in the age group of 80 to < 85 years old, and then decreased. The crude incidence rates of gastric cancer among residents in the age groups of 15 to < 45 years old and 45 to < 55 years old showed a downward trend (AAPC=-4.622%, -3.147%, both P < 0.05), while there was no changing trend in the age groups of 55 to < 65 years old and 65 years old and above (AAPC=-1.487%, 1.315%, both P > 0.05). The main sites of gastric cancer were concentrated in the gastric antrum, gastric body, and cardia. Conclusion From 2014 to 2023, the crude incidence rate of gastric cancer remained stable in Wenzhou, but the standardized incidence rate showed a downward trend. Men, middle-aged and elderly people were high-risk groups. Therefore, intervention should be carried out against risk factors, and screening and eradication of Helicobacter pylori infection and gastric cancer screening should be strengthened to reduce the incidence rate of gastric cancer.