Hypoechoic lesions of the gastric fundus lamina propria are considered to be related to gastric smooth muscle tumor and gastric mesenchymal stromal tumor, and patients can be treated with surgery and medication. 1. Gastric smooth muscle tumor: Gastric smooth muscle tumor is mainly resected by surgery. If the volume of gastric smooth muscle tumor is large, partial gastrectomy or total gastrectomy is feasible when necessary. Since gastric smooth muscle tumor is not sensitive to chemotherapy and radiation therapy, it is often not used. 2. Gastric mesenchymal tumor: Gastric mesenchymal tumor is preferred to be treated by surgery, which is aimed at complete resection of the lesion, and rupture of the tumor should be avoided during the operation. Generally speaking, gastric mesothelioma rarely has lymph node metastasis, so there is no need to perform lymph node dissection. Some patients with gastric mesenchymal tumors can also be treated with molecularly targeted drugs, such as imatinib, sunitinib, regorafenib, etc.. It is recommended that patients with hyperechoic lesions of the gastric fundus intrinsic muscular layer undergo further detailed examination in order to clarify the cause of the disease and then follow the doctor’s instructions for treatment. Pay attention to the rationality of daily diet, avoiding the intake of stimulating food, in order to minimize the stimulation and damage to the stomach.