Since it is difficult to distinguish smooth muscle tumor from smooth muscle sarcoma, and smooth muscle tumor can become malignant, it should be dealt with. For smooth muscle tumors with a single tip and a tumor diameter of <2 cm, endoscopic electrosurgery can be performed; for multiple non-tipped ones with a diameter of >2 cm, or those with symptoms such as bleeding or obstruction, or those with malignant changes suggested by endoscopic biopsy or puncture biopsy, laparoscopic or caesarean resection should be given. For smooth muscle tumor of gastric body, sinus and fundus with diameter <5cm, if the tumor is clearly defined, no necrosis, no ulceration of gastric mucosa in the tumor area, and no metastasis in the abdominal cavity, local resection of the tumor is feasible, and the smooth muscle tumor located in the pylorus and cardia area can be removed 1cm away from the tumor. When the tumor diameter is <3cm, conservative local excision or wedge resection with part of the gastric wall is feasible. Gastric smooth muscle tumor with a diameter of <2cm can be completely removed by endoscopic mucosal excision, which is less expensive, quicker to recover and less traumatic. Gastric smooth muscle tumors less than 2 cm can be resected endoscopically, while those over 2 cm with bleeding, obstruction and malignancy can be considered for laparoscopic resection or caesarean section.