Pregnancy-associated gastric cancer is rare and has a poor prognosis. Most cases present at an advanced stage, the diagnosis often being delayed because the symptoms may mimic those of normal pregnancies. Also, treatment options are limited: surgical resection is an option for about half of the patients, chemotherapy regimens may have serious consequences for the fetus – often termination of pregnancy may be required, and the prognosis is dismal. We report the case of a 39-year-old female, 23 weeks pregnant, who presented with nausea, vomiting, and significant weight loss. Laboratory tests showed hypochromic microcytic anemia, thrombocytopenia, left shift with leukoerythroblastosis. Bone marrow aspiration was suggestive for metastases. Further investigations established the diagnosis of poorly differentiated gastric adenocarcinoma stage IV.