Ultrasound gastroscopy lesions are hypoechoic due to gastric ulcer, gastric smooth muscle tumor, gastric lymphoma and other diseases, which need to be treated by drugs or surgery. 1. Gastric ulcer: usually due to gastric ulcer, the structure of gastric tube wall layer is damaged, resulting in local thickening of gastric wall and local defect of gastric wall mucous membrane layer, which causes hyperechoic ultrasound gastroscopy lesions. Omeprazole and other drugs can be used to treat it as prescribed by the doctor, and if it is accompanied by Helicobacter pylori infection, it can be treated with amoxicillin + clarithromycin + omeprazole + bismuth quadruple anti-infective therapy. 2. Gastric smooth muscle tumor: it may be due to gastric smooth muscle tumor, resulting in localized swelling of the gastric mucosa, the fundus of the stomach bulging, thus appearing ultrasonic gastroscopy lesions were hypoechoic. It can be treated with surgical resection in the hospital. 3. Gastric lymphoma: it is generally due to gastric lymphoma, which causes local thickening of gastric lining, disappearance of peristalsis of gastric lining and elevation of gastric lymphatic tissues, thus the ultrasonic gastroscopy lesion is hypoechoic, and it can be surgically resected as well as treated with chemotherapy. Hypoechoic ultrasound gastroscopy lesions may also be associated with gastric polyps and other diseases, which should be promptly examined in a hospital and treated under the guidance of a doctor.