Objective: To explore the value of endoscopic ultrasonography in upper gastrointestinal mesenchymal tumors.Methods:From January 2019 to May 2020,80 patients with gastrointestinal mesenchymal tumor (gastrointestinal mesenchymal tumaors,GIMTs) were diagnosed by regular endoscopic examination. All patients were examined by endoscopic ultrasound, and the treatment was selected according to the endoscopic manifestations. Observe and analyze the diagnostic efficacy and surgical guidance value of endoscopic ultrasonography in GIMTs.Results:15 cases of lipoma detected by EUS, In 10 cases, Sensitivity 83.33%(10/12), specificity 92.65%(63/68); Detection of leiomyoma in 44 cases, In 37 cases, Sensitivity 88.10%(37/42), specificity 81.58%(31/38); In 22 cases, In 19 cases, Sensitivity 73.08%(19/26), specificity 94.44%(51/54), Lipomas are mostly found in the stomach (66.67%), originating from the mucosal muscular layer (50.00%) or submucosa (50.00%); leiomyoma is mostly distributed in the stomach (83.33%), originating from the mucosal myometrium (83.33%); Most stromal tumors are found in the stomach (76.92%), originating from the lamina propria (38.46%). 60 cases diagnosed by ultrasound GIMTs guided by gastroscopy, The operation was successful, No perforation, Bleeding, Two months after surgery, all patients had good wound healing, The tumor did not recur.Conclusion:Endoscopic ultrasonography is effective in the diagnosis of upper gastrointestinal mesenchymal tumors and has important guiding value for gastrectomy.