The aim of the study was, by the mean of a representative patient group, to investigate frequency, profile of tumor sites, extension & characteristics of tumor growth of gastric GIST related to patient characteristics, diagnostic/therapeutic spectrum & outcome in daily surgical practice. Patients & Methods: Out of a prospective, multicenter observational study on quality control in surgery with 1,199 consecutive patients with gastric carcinoma(Ca) or GIST from 01/01/2002-12/31/2002, a case series of patients with GIST was studied with regard to the diagnostic criteria, the treatment results such as operation & resection rate, spectrum of surgical interventions, perioperative morbidity, hospital mortality & results of the 3-year follow up. Results: In total, 55 cases with GIST (55/1,199; 4.6 %) were treated (mean age, 62 years; sex ratio, m/w=33/22), out of which 29 % (n=16) were malignant. In the diagnostic profile, gastroscopy (87.3 %), abdominal ultrasound (81.8 %) & CT scan (67.3 %) were predominant (EUS, 35.5 %). Tumor sites were distributed as follows: Corpus (n=19; 41,3 %); antrum/pylorus (n=16; 34.8 %). Histologic diagnosis was preoperatively clarified in only 47.3 % (n=26; no histologic diagnosis, n=18; 32.7 %). All patients underwent surgical intervention; 94.5 % (n=52) were curative (R0) (lymph node metastases, n=5; 5.5 %/non-local metastases, n=2; 3,6 %). A limited tumor resection predominated with 61.8 % (n=34) versus 36.4 % (n=20) with radical resection (gastric Ca, 6.6 % & 78.9 %, respectively) combined with no or with lymphadenectomy: 65.5 % (n=36) & 34.5 % (n=19), respectively. The perioperative morbidity was 23.6 % (n=13; gastric Ca, 42.0 %); the mortality was 0 % (gastric Ca, 8.6 %). The 3-year follow up (range, 2.5-3.5 years) showed a tumor-free survival of 88.7 % (n=47/53); one patient could not be followed, & one patient declined follow-up investigation (1.8 % each). In 4 cases (7.5 %), metastases were found: Liver (n=2); liver/spleen & lung (n=1 each). There was no local recurrent tumor growth; the overall survival was 98.1 % (n=52/53). Conclusion: Gastric GIST represent approximately 5 % of primary gastric tumor lesions. A lymphogenic metastatic tumor growth occurs rarely (5.5 %), however, it can not be totally excluded, in particular, in advanced tumor stages. The predominantly limited surgical interventions can provide a healing rate of more than 90 % associated with a low perioperative morbidity & mortality.