A gastric lipid spot is a gastric xanthoma, which requires a biopsy. Gastric luteoma is a benign lesion of the stomach that is actually due to lipid deposition in the gastric mucosa. Although the probability of cancer is very low, it has to be distinguished from gastric impression cell carcinoma, and the general way to distinguish it is to do biopsy after gastroscopy, especially the larger diameter of gastric xanthoma, pathological biopsy has to be taken, and the smaller ones can be followed up regularly. Gastric xanthomas have no special clinical manifestations, mostly occurring in middle-aged and old people, through gastroscopy can be found on the gastric mucosa with small gray spots, and will coexist with chronic atrophic gastritis and other symptoms. Generally, male patients with this disease are more common, the size of 5mm or less, and the clinical manifestations are not specific, similar to chronic gastritis. It is recommended that patients diagnosed with gastric xanthomas undergo timely pathologic examination and regular follow-up to avoid abnormalities.