Abstract: Objective:To analyze the guidance value of multi-slice spiral computed tomography (MSCT) in the diagnosis and clinical treatment of gastric stromal tumor (GST). Method:The clinical data of 56 patients with gastric stromal tumor admitted to our hospital from January 2018 to February 2019 were collected. The clinical data of patients were collected to evaluate the pathological risk of patients. The differences in MSCT images between patients with different pathological risks were analyzed, and the diagnostic accuracy of MSCT for GST was calculated. Results:Among the 56 patients, 11 patients (19.64%) had very low pathological risk, 18 patients (32.14%) had low risk, 14 patients (25.00%) had moderate risk, and 13 patients (23.21%) had high risk. There was no significant difference in the density of MSCT, the presence or absence of necrosis/ulcer in the tumor, the difference value of degree of of arteriovenous enhancement, the presence or absence of the intravascular and peritumoral vessels, and the pathological risk (P>0.05). There was a significant difference in peritumoral fat space, enhancement mode and pathological risk (P<0.05). Taking pathological biopsy as a control, the number of accurate diagnosis of GST by MSCT was 53 cases, and the diagnostic accuracy was 94.64%. Three cases were misdiagnosed as gastric cancer, and the misdiagnosis rate was 5.45%. Conclusion:MSCT has a high diagnostic accuracy for GST, which can effectively display the characteristics of GST images with different pathological risks, and can provide reliable imaging information for clinical operations.