Fibroblasts play important functions in the synthesis and remodeling of extracellular matrix and are involved in physiopathological processes such as maintaining tissue structure, mediating immune regulation, inflammation and tumorigenesis. Fibroblasts participate in and maintain the atrophy and chemotaxis of the gastric mucosa in the precancerous stage. When the gastric mucosa becomes cancerous, the activated fibroblasts interact with gastric cancer cells and other components of the tumor microenvironment, shaping a microenvironment suitable for the growth of gastric cancer and thus promoting gastric cancer proliferation, invasion, and metastasis, but the mechanism of action is complex and needs to be further explored. Meanwhile, fibroblasts have been found to be closely associated with chemoresistance in gastric cancer. Therefore, drugs targeting fibroblasts may provide a new direction for cancer treatment and play an important role in reducing the risk of cancer recurrence and metastasis, decreasing chemoresistance and improving cancer prognosis.In this study, we provide a review on the mechanism of fibroblasts promoting gastric mucosal carcinogenesis and their role in evaluating the effect of gastric cancer drug therapy, in order to provide a theoretical basis for the study of the role of fibroblasts in the pathogenesis and treatment of gastric cancer.