The objective of the present study was to clarify the influence of introduction of clinical pathways on the nutritional status of patients undergoing distal gastrectomy. We investigated changes in the nutritional status of the patients at admission and discharge, before and after the introduction of clinical pathways.A group consisted of 32 patients who had undergone distal gastrectomy before introduction of clinical pathways (22 males and 10 females with the average age of 66.2±12.0) was regarded as the control group, and another group consisted of 31 patients who had undergone distal gastrectomy after introduction of clinical pathways (21 males and 10 females with the average age of 64.2±9.2) was regarded as the pathway group. Both groups were compared on body weight, body mass index (BMI), body weight reduction rate, serum albumin, hemoglobin, energy intake and energy intake adequacy.While body weight and BMI at the time of discharge significantly reduced in both groups as compared with those at the time of admission (p<0.001), body weight reduction rate was significantly lower in the pathway group, i.e., 8.7±4.0% in the control group and 6.4±4.6% in the pathway group (p<0.05). While the level of serum albumin significantly lowered in both groups at the time of discharge as compared with that at the time of admission (p<0.001), the ratio of hypoalbuminemia at the time of discharge was significantly lower in the pathway group (p<0.05), i.e., 50.0% in the control group and 22.6% in the pathway group. While the hemoglobin level of the control group significantly lowered at the time of discharge as compared with that at the time of admission (p<0.001), no significant difference between those two times was observed in the pathway group. The energy intake was 1, 421±508kcal in the control group and 1, 618±437kcal in the pathway group, and the energy intake adequacy was 84.8±28.8% in the control group and 96.0±28.9% in the pathway group.Based on the above findings, it is considered that changes in the aspect of hospital management-such as promotion of team medical services, standardization of medical care, and disclosure of information, all of which had been made possible by introduction of clinical pathways-deepened the pathway group's understanding on the diet therapy, and improved their nutritional status through increased nutrient intake; and that, because of this, the nutritional status of the pathway group at the time of discharge was better than that of the control group. Therefore, it is suggested that introduction of clinical pathways restrains the decline of nutritional status of patients after distal gastrectomy.