In the NCCN guidelines and Chinese guidelines, the treatment recommendations for small GIST are if there are no high-risk features (such as irregular borders, cystic cavity, ulceration, hyperechoic lesions, and heterogeneity) under endoscopic ultrasound, the patient will only require endo­scopic ultrasound follow-up every 6–12months, without sur­gery. However, there are certain factors in the clinical practice which interfere with this recommendation, includ­ing (1) endoscopy is subjective, and the diagnostic accuracy is greatly affected by the operating doctor; (2) the patient’s anxiety about the disease seriously affects the quality of life, and the follow-up time, and economic costs and patient com­pliance can lead to failure to follow up in the manner recom­mended by the guidelines; (3) With the development of minimally invasive techniques, some surgeons believe that minimally invasive surgery can be used to completely remove the lesions at a relatively low cost. The more important rea­son is that not all small GIST exhibit benign biological behaviors. The author retrospectively analyzed China Gastrointestinal Stromal Tumor Study Group (Guangdong Provincial People’s Hospital, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, and Tumor Afliated to Sun Yat- Sen University Hospital, Southern Hospital of Southern Medical University).