A 56-year-old man complained of abdominal pain. On abdominal CT, free air and gastric wall thickening were noted. He was diagnosed as having a gastrointestinal perforation and peritonitis due to a suspected gastric cancer. Since his symptoms were not severe, emergency surgery was postponed. On endoscopy, a perforated gastric tumor was found. A distal gastrectomy with D2 lymphadenectomy and cholecystectomy was scheduled. A liver metastasis was found on laparotomy. Since a solid mass measuring 1.5 cm in diameter was detected in S3 of the liver, a partial hepatectomy was also done. On histopathology, the tumor located in the ventriculus of the stomach was diagnosed as a moderately differentiated adenocarcinoma. The final diagnosis was T3 N1 H1 P0 M0 fStageIV. Adjuvant chemotherapy using S-1 was given. Tumor markers, especially CA72-4, became transiently elevated two years later, but normalized after continuous adjuvant chemotherapy with S-1. There have been no signs of recurrence for 5 years. Generally, it is considered that gastric cancer patients with liver metastasis and a perforation have a poor prognosis. Therefore, we report this rare case that has shown a good postoperative course for 5 years.