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Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract. GISTs are found most commonly in the stomach; followed by the small bowel, colon and rectum, esophagus, and extragastrointestinal tract. On initial staging evaluation of GISTs, the radiologist must determine the organ of origin; size; local invasion; and distant metastases, typically to the liver and peritoneum. If additional lesions are found in other locations, then syndromes related to GISTs must be considered. These include Carney triad, Carney-Stratakis syndrome, neurofibromatosis type 1 (NF1), and familial GIST syndrome. During follow-up imaging, the tasks of the radiologist are to detect residual or recurrent disease, evaluate response to therapy, and identify distant metastases while being vigilant for nonsyndromic metachronous tumors.