Abstract Background: Latin-America is one of the regions with the highest incidence of gastric cancer. Even though, there are not reports about the patterns of pleural and pulmonary metastases in patients with gastric adenocarcinoma treated with curative intent and the prognosis according to each dissemination pattern. Methods: retrospective cohort study at the Instituto Nacional de Cancerología-Colombia. Results: the study included 450 patients, 51.3% were male and the median age was 63 years. Intestinal adenocarcinoma was the most frequent histological subtype, in 261 cases (58.0%). Gastric cancer initial pathological stage was stage I in 23.3% of the patients, stage II in 19.3% and stage III in 53.6%. During a median follow-up of 31.9 months, 37(8.2%) patients developed lung or pleural abnormalities; among those, 14(3.1%) met the criteria for pleuro-pulmonary metastases: 6(1.3%) had lymphangitic metastasis, 4(0.9%) had a mixed pattern of pleural and lung nodules, 3(0.7%) had pleural metastasis, and only one (0.2%) had hematogenous metastasis. The median overall survival was 114.5 months for the entire cohort and 38.2 (95%CI,19.2–57.2) months for patients with pleuro-pulmonary metastases. Patients with pleural metastasis and lymphangitic carcinomatosis had median survival of 24.3 (95%CI,0.01–51.0) and 26.4 (95%CI,18.2–34.7) months, respectively. Conclusions: incidence of pleuro-pulmonary metastases in patients with gastric adenocarcinoma treated with curative intention was low. In our series, lymphangitic carcinomatosis was the main pattern of dissemination; meanwhile, hematogenous metastasis was rare and patients with pleural carcinomatosis had the lowest median survival. These findings and their prognosis were different compared to those reported in Eastern countries.