Objective To evaluate the correlation of serum lipids before radical gastrectomy for gastric cancer (GC) with clinicopathological characteristics and prognosis. Methods A total of 307 GC patients underwent radical gastrectomy in the Second Hospital of Lanzhou University from October 2019 to May 2020 were retrospectively analyzed. The clinical data were compared to explore the correlation between serum lipids 2 weeks before radical gastrectomy and the prognosis. Results The follow-up time of 307 GC patients was 1-79 months, with a median follow-up time of 52 months. As of the final follow-up time, a total of 72 patients were lost to follow-up in this study, and 235 patients were finally included, of which 111 patients died. The preoperative increase in total cholesterol (TC) was significantly correlated with gender, pathological T stage(pT), pathological N stage(pN), carcinoembryonic antigen (CEA) and neurovascular invasion (P<0.05). High levels of triglyceride (TG) was significantly correlated with tumor maximum diameter, vascular invasion, pathological differentiation, pT, pN, and body mass index (BMI) (P<0.05). The increase in the low-density lipoprotein cholesterol (LDL-C) was significantly correlated with increased BMI, pT, pN,CEA and perineural invasion (P<0.05). Cox univariate risk analysis was performed on 235 GC patients treated with radical gastrectomy. Tumor maximum diameter, tumor location, vascular invasion, nerve invasion, CEA, carbohydrate antigen (CA) 125, CA199, pT, pN, TC, TG and LDL-C were all risk factors for the overall survival after radical gastrectomy (P<0.05). Multivariate analysis showed that after excluding other confounding factors, tumor size, CEA, CA125, CA199, pT, BMI and LDL-C were the independent risk factors for the prognosis of gastric cancer (P<0.05). Conclusion Preoperative LDL-C can be used as an independent factor to predict the prognosis of GC after radical gastrectomy.