OBJECTIVES:  Little evidence is available on the management of patients with Advanced Gastric Cancer (AGC) after failure of 1^st-line treatment. This study presents real-world data on patient characteristics and treatment patterns for these patients in Brazil. METHODS:  Data from medical charts were collected from 5 centers. Eligible patients were ≥18 years old, diagnosed with unresectable or metastatic GC, between January 2011 and December 2014, had received 1^st-line chemotherapy treatment, had ≥3 months of follow-up after 1^st-line discontinuation, and had not participated in a clinical trial. Data were summarized using descriptive statistics. RESULTS:  Out of 494 charts screened, 154 were eligible (n=98 [63.6%] from public healthcare institutions). Mean age was 61.1 years and 57.1% of patients were male; 55.2% and 18.8% progressed to second- and third-line therapies, respectively. ECOG performance status (PS) during 1^st-line treatment was PS=0 in 25.0%, PS=1 in 59.5%, and PS=2 in 14.7%. During 2^nd-line treatment, it was PS=0 in 18.2%, PS=1 in 54.6%, and PS=2 in 25.5%. Twenty-one and 19 different regimens were used as 1^st- and 2^nd-line treatments, respectively. CapeOx (31; 20.1%), FOLFOX (26; 16.9%) and EOX (14; 9.1%) were the most frequent 1^st-line regimens, while irinotecan (29; 34.1%), paclitaxel (16; 18.8%) and CapeOx (5; 5.9%) prevailed in 2^nd-line treatment. Supportive care was observed among 14.5% of the patients, only after 1^st-line treatment. The median overall survival since AGC diagnosis was 16.9 (95%CI [13.6-20.5]) months in all patients, and 15.0 (95% CI [12.4-19.3]) and 20.0 (95% CI [15.4-27.6]) months in patients from public and private institutions, respectively (p=0.23). CONCLUSIONS:  Treatment patterns for patients with AGC in Brazilian institutions are highly heterogeneous. The low rates of supportive care without active treatment warrant further study The results of this study may contribute to the development of new strategies and guidelines for AGC management in Brazil.