Objective To investigate the clinical diagnosis value of endoscopic ultrasonography (EUS) in upper gas-trointestinal tract bulgy lesion with smooth surface. Methods All 98 cases of patients with upper gastrointestinal tract bulgy lesion with smooth surface found by routine gastroscopy examination. They were examined by EUS and compared with pathologic examination. Results 65 cases were polypuse,10 cases were stromal tumor,5 cases were leiomyoma,7 cases were lipoma,4 cases were heterotopic pancrease,2 cases were cyst, 3 cases were venous aneurysm,2 cases were external pressure change. The diagnostic accordance rate of EUS and pathology examination were 93.68%. Con-clusion EUS can accurately determine the origin of upper gastrointestinal tract bulgy lesion with smooth surface. It is very important for treatment and evaluating prognosis.