Abstract: This study aimed to investigate the effects of vacuum packaging combined with vitamin E or ginger extract treatment on the flavor quality and lipid oxidation stability of cooked Eriocheir sinensis after refrigeration-reheating. Cooked E. sinensis were divided into four groups: control group (CG), vacuum group (VG), vacuum vitamin E group (VVEG), and vacuum ginger extract group (VGEG). After storage at 4 °C and subsequent reheating, changes in sensory evaluation, volatile flavor compounds, lipid oxidation indices, and fatty acid composition were determined. Compared with the CG group, VG, VVEG, and VGEG significantly inhibited the increase in TVB-N during storage, with VVEG extending the shelf life up to 15 days. Sensory evaluation indicated that the VGEG was most effective in reducing fishy and rancid odors. GC-MS analysis revealed that VVEG and VGEG significantly reduced the content and odor activity values (OAVs) of key fishy odor compounds such as hexanal, nonanal, and 1-octen-3-ol. Lipid oxidation analysis demonstrated that vitamin E and ginger extract effectively inhibited lipid oxidation. Vitamin E showed a greater advantage in inhibiting the accumulation of secondary oxidation products and reducing the oxidative degradation of EPA and DHA. This study indicates that vacuum-packaging combined with vitamin E or ginger extract can effectively inhibit li pid oxidation and reduce the degradation of fatty acid precursors of fishy odor. This research provides a feasible strategy for flavor preservation and lipid stability of cooked E. sinensis after refrigeration-reheating.