Gastric cancer liver metastasis (GCLM) is the most common hematogenous metastatic pattern of gastric cancer and a critical determinant of poor prognosis. Its management remains highly challenging and requires complex clinical decision-making as well as multidisciplinary team (MDT) collaboration. In recent years, a deeper understanding of gastric cancer heterogeneity—particularly the release of the Chinese Consensus Classification for Gastric Cancer Liver Metastasis (C-GCLM) and vigorous development of molecular subtyping research—has catalyzed a paradigm shift in the management of GCLM. The conventional approach, characterized by empirical decision-making and single-modality interventions, is gradually being replaced by a precision-based, MDT-driven model that emphasizes integrated, whole-course care. This review systematically summarizes the epidemiological characteristics and advances in diagnostic technologies for GCLM, with a focus on comprehensive treatment strategies based on the C-GCLM and molecular subtyping.