Systemic chemotherapy is the mainstay of therapy in patients with advanced gastric cancer, but has multiple drawbacks including lack of durable efficacy and dose limited toxicities. Recent clinical trials data on the efficacy of immune therapy in this patient group have shed light on its potential as an alternative treatment option. Recently, immunotherapy with antibodies that inhibit the programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) interaction has emerged as a new treatment option. Although the toxicity of checkpoint inhibitors is generally unpredictable, they tend to be more manageable and better tolerated than the toxicities of systemic chemotherapy. Results from ongoing phase 3 trials are needed to further evaluate the potential roles of these agents within the continuum of care.