This study evaluated the efficacy and safety of docetaxel, cisplatin and 5-fluorouracil/leucovorin as neoadjuvant chemotherapy before surgery (NCT group; n = 29) compared with postoperative chemotherapy alone (non-NCT group; n = 26) in the treatment of Borrmann type IV gastric carcinoma. Primary tumour response rate, surgical parameters, incised-edge residue rate, lymphatic metastasis status and side-effects were evaluated. The overall response rate was 58.6% in the NCT group, which included three (10.3%) patients in complete remission and 14 (48.3%) patients in partial remission. The postoperative pathological complete response rate was 6.9% (two patients) in the NCT group. NCT was associated with a significant increase in the radical resection rate and a significant decrease in the rate of incised-edge residues, compared with postoperative chemotherapy alone. Side-effects due to NCT were minimal and resolved with appropriate treatment. There were no chemotherapy-related deaths in either group. In conclusion, docetaxel, cisplatin and 5-fluorouracil/leucovorin was an effective and well-tolerated NCT regimen for Borrmann type IV gastric cancer.