Gastrointesti-nal stromal tumor (GIST) is a tumor of mesenchymal tissue originating from the gastrointestinal tract and abdominal cavity, with spindle-shaped or epithelial cells and positive immunohistochemical c-kit staining; unlike other common malignant tumors of the gastrointestinal tract, GIST is a tumor of undetermined malignant potential. The median age of onset is between 55-65 years old, with rare onset before 40 years old and even rarer in children; the male to female ratio is comparable (1.2:1). GIST occurs most frequently in the stomach (60%-70%), followed by the small intestine (20%-30%), the colon and rectum account for only 5%, the esophagus accounts for 0%-5%, and occasionally occurs in the omentum and mesentery. In the past, almost all tumors occurring in the gastrointestinal tract with predominantly spindle cells or epithelioid cells were classified as smooth muscle tumors and were once called smooth muscle tumors, smooth muscle sarcomas or smooth myoblastomas; at present, there is a consensus that GIST is a mesenchymal tissue tumor with unique biological characteristics, which is different from typical smooth muscle and neurogenic tumors and does not have the classical differentiation characteristics of smooth muscle tumors and nerve sheath tumors. In recent years, approximately 700 surgical resection cases have been documented in domestic and international literature, with surgical resection rates of 40%-92% and 5-year survival rates of 47.2%-57%. Immunohistochemical methods showed positive CD117 in nearly 95% of GISTs. The principles of surgical treatment for gastrointestinal mesenchymal tumors vary depending on the site of the tumor: (1) Gastric GIST: It is generally accepted that it should be at least 2 cm from the tumor margin. (2) Duodenal GIST: the site is special. For the elderly, low malignancy and small tumor, only local resection can be performed to avoid additional surgical complications, but it is required that there is no tumor cell residue (frozen section) under the microscope of the cutting edge; for young patients and those with large tumor but no dissemination, pancreaticoduodenectomy should be considered regardless of its malignancy, because the treatment effect of its local recurrence is extremely poor. (3) Rectal GIST: if the tumor is ≤2 cm in diameter, tumor removal should be performed; if 2-5 cm, local resection or anterior resection or Miles surgery should be considered; if ≥5 cm, anterior resection or Miles surgery should be performed. It should be emphasized that surgery is still the only radical means for GIST patients, and surgical resection should be performed as much as possible. Expanded resection or systematic extensive lymph node dissection is not routinely recommended for GIST. If the tumor invades or infiltrates adjacent organs, it is not advisable to separate the tumor reluctantly for complete resection, and only combined organ resection can be performed; before deciding on multi-organ resection, it is necessary to confirm the absence of abdominal dissemination and distant metastasis. If abdominal dissemination is present, multivisceral resection is of little significance. Complete resection is the standard of care for GIST, and conventional chemotherapy and radiotherapy are ineffective. The median survival after GIST is 48-66 months; the recurrence rate is 40%-90%, and liver, lung and bone metastases often occur. Clinical data show that for patients at high risk of postoperative recurrence, adjuvant therapy with imatinib can significantly improve disease-free survival, and postoperative adjuvant therapy should be given for at least two years for high-risk patients, and is recommended for life. In clinical workup, adjuvant therapy with imatinib should be used as early as possible for patients known to be at high risk of postoperative relapse. For patients who have relapsed, the disease status should be fully evaluated for surgical opportunities and postoperative adjuvant therapy with imatinib should be given.