Objective To discuss the clinical application of totally laparoscopic surgery combined with intraoperative removed the specimen through the oral in treatment for gastric stromal tumor. Methods The clinical data of 20 patients diagnosed gastric stromal tumor and performed totally laparoscopic surgery combined with intraoperative removed the specimen through the oral in treatment for gastric stromal tumor from January 2007 to August 2009 in our hospital were analyzed retrospectively. Results All the cases were performed successfully laparoscopic operation. The operation time was (110±35) min, intraoperative bleeding was (60±15) ml,postoperative hospital stay was (6.5±1.2) d. No postoperative complications occurred. There were 19 cases no relapse during 0.5-2.5 years with (1.8±0.2) years of follow-up. One patient with recurrence was performed the laparoscopic proximal subtotal gastrectomy. Conclusions Totally laparoscopic surgery combined with intraoperative removed the specimen through the oral in treatment for gastric stromal tumor is safe, feasible, and minimally invasive for patients due to its clearness of dissection, less bleeding, and removed the specimen through natural channel.