Objectives: This study examines the epidemiological trend of gastric cancer (GC) in all Saudi Arabian administrative areas. It examines the incidence of diagnosed cases, the age-specific incidence rate (AIR), the crude incidence rate (CIR), and the age-standardized incidence rate (ASIR) stratified by age group, year of diagnosis, and region. Methods: From 2004 to 2017, a retrospective descriptive epidemiological study of all GC cases recorded in the Saudi Cancer Registry (SCR) was conducted. The data were analysed with descriptive statistics, the t-test, the Kruskal-Wallis test, and the sex ratio using version 20.0 of the Statistical Package for the Social Sciences (SPSS). Results: Between January 2004 and December 2017, a total of 4,066 GC cases were reported in the SCR. Riyadh, Najran, and Eastern Region had the highest overall ASIR of GC among males and females in Saudi Arabia (Males: 4.0, 3.8, and 3.8; Females: 2.6, 2.3 and 2.2 per 100,000 people). In contrast, Jazan had the lowest overall ASIR of GC among Saudi males and females (1.5 and 0.5 per 100,000 people, respectively). However, the overall ASIR of GC was statistically higher in men than in women (P-value 0.05), with a male-to-female ratio of 2.8 per 100,000 in Saudi Arabia. Conclusion: There was a small decline in the CIRs and ASIRs of GC in Saudi Arabia Between 2004 and 2017. Riyadh, Najran, and the Eastern Region had the greatest prevalence of GC among males and females in Saudi Arabia. Men and women in Jazan, Saudi Arabia, were shown to be the least impacted by GC. In Saudi Arabia, the rates of GC were substantially greater among males than among females.