Primary gastric squamous cell carcinoma (PGSCC) is a rare form of gastric malignancy. The etiology remains unclear and no standardized treatment protocol or consensus has been established. The current study presents a rare case of PGSCC treated by total gastrectomy and extended D2 lymphadenectomy, alongside a review of related clinical literature. A 57-year-old man was diagnosed with primary SCC located at the lesser curvature of the gastric body. The patient underwent a total gastrectomy and extended D2 lymphadenectomy. Postoperative pathology confirmed a moderately differentiated SCC with perineural invasion, classified as stage T4bN2M0. Treatment strategies for PGSCC remain controversial, underscoring the need for further studies with larger sample sizes to clarify therapeutic approaches.