Objective To investigate the cause of gynecological misdiagnosis in small intestinal stromal tumor and operation principle,treatment protocol.Methods Gynecological misdiagnosis in 4 female patients with small intestinal stromal tumor admitted were retrospectively analyzed.Results Four patients had abdominal ultrasound examination,1 patient was misdiagnosed as hysteromyoma,3 patients were misdiagnosed as ovarian tumor.All patients without further abdominal CT or MRI examination,operated by gynecology first and then treated by general surgery.All of 4 patients were confirmed with small intestinal stromal tumor by pathology.Conclusions For patients who are considered with hysteromyoma or ovarian tumor have melena must be identified with small intestinal stromal tumor.Further CT examination is valuable and can reduce misdiagnosis.Operation principle and oral imatinib mesylate after operation must be insisted.