Gastric cancer remains one of the leading causes of cancer-related mortality worldwide. Lymph node metastasis (LNM) is the most important prognostic factor influencing staging, treatment strategy, recurrence, and overall survival. Accurate prediction of nodal involvement before and after surgery assists clinicians in determining the extent of lymphadenectomy and selecting patients for neoadjuvant or adjuvant therapy. Histopathological characteristics such as tumor size, depth of invasion, histological subtype, tumor differentiation, lymphovascular invasion, perineural invasion, tumor budding, desmoplastic response, and molecular biomarkers have been consistently associated with an increased likelihood of lymph node metastasis. Recent advances in digital pathology, immunohistochemistry, artificial intelligence, and molecular profiling have further enhanced risk prediction. This review summarizes the current evidence regarding histopathological predictors of lymph node metastasis in gastric cancer and discusses their clinical significance, diagnostic utility, and future applications.