Increasing evidence indicated that insulin-like growth factor binding protein 7 (IGFBP7) was regarded as a potential tumor suppressor in various human cancers, but its role in gastric cancer is still largely unknown. In the present study, we performed a retrospective study which includes 247 gastric cancer patients. Among them, the IGFBP7 expression was detected by qRT-PCR in 138 cases of gastric cancer and adjacent non-tumor tissues and was further correlated with the expression of p53, Ki-67, and the clinicopathologic features. The results indicated that both IGFBP7 mRNA and protein in gastric cancer tissues were significantly lower than those in the adjacent non-tumor tissues. Additionally, the expression of IGFBP7 was correlated with the depth of invasion, lymph node metastasis, and TNM stage. Interestingly, the expression of IGFBP7 was negatively associated with Ki-67 (r = -0.227, P < 0.001) but positively associated with p53 (r = 0.140, P = 0.028). Univariate analysis showed that low expression of IGFBP7 was associated with poor prognosis (P < 0.001), and multivariate analysis showed that IGFBP7 (HR = 1.87; 95 % CI 1.65-2.17), distant metastasis (HR = 2.68; 95 % CI 1.58-4.56), and tumor size (HR = 1.45; 95 % CI 0.90-2.32) were independent prognostic factors for gastric cancer patients. These results demonstrated that IGFBP7 was downregulated in gastric cancer, and its low expression was potentially correlated with increased cancer cell proliferation and could be used to predicate poor prognosis in these patients.