Abstract: Objective To assess the risk factors for osteoporosis in patients with gastric cancer in the early postoperative period, so as to reduce or prevent the occurrence of postoperative osteoporosis. Methods Clinical data about 81 patients with gastric cancer who underwent radical gastrectomy in the First Affiliated Hospital of Henan University of Science and Technology from January 2015 to December 2016 were retrospectively analyzed. Of the 81 cases, there were 66 males and 15 females with age ranging from 28 to 89 years old. CT value was used to quantitatively measure bone density of the first lumbar vertebral trabecular bone before and at 3-6 months after operation. The patients were divided into two groups using CT value of 145 HU as the cut-point, and the risk factors of postoperative osteoporosis were analyzed between the two groups. Results Univariate analysis showed that there were significant differences in history of smoking, history of diabetes, surgical site and the method of surgical anastomosis between the two groups(P < 0.05). Multivariate logistic analysis showed that history of smoking(OR, 7.175; P=0.040) and total gastrectomy(OR, 49.196; P=0.002) were risk factors for early postoperative osteoporosis in patients with gastric cancer. Conclusion Smoking history and total gastrectomy are the risk factors for osteoporosis in patients with gastric cancer.