Abstract: To study vasculogenic mimicry (VM) and its role in gastrointestinal stromal tumors (GISTs). Methods: Specimens of 84 GIST cases were collected along with their clinicopathologic data. VM channels were detected using CD31/PAS double staining and CD117 and CD31 immunohistochemical staining and were then used to study the correlation between VM and clinicopathologic factors.Results: VM channels were found in 21 of the 84 GIST cases. There was a significant difference in the VM- positive rate between the group with a mitotic rate of greater than or equal to 5/50HPF and the group with a mitotic rate of less than 5/50HPF. There was also a significant difference between the cases with and without liver metastasis (P=0.000, 0.008). The VM- positive rate in the ultra- low/lowrisk,intermediate- risk and high risk groups was 5.9%, 12.5% and 39.5%, respectively. There was a significant difference when comparing the VM- positive rates between the three groups (P=0.010, 0.020).Kaplan-Meier survival analysis showed the presence of VM channels had a negative influence on prognosis (P=0.0000). Cox' s proportional hazards model analysis indicated that the presence of VM channels,tumor size of 10 cm or larger and hemorrhaging were independent predictors of poor prognosis for the GIST patients (P=0.000, 0.005, 0.032). Conclusion: VM exists in GIST. VM is an unfavorable factor influencing prognosis of GIST patients, and the patients with VM channels in the tumor are prone to suffer liver metastasis. Prognosis for patients with VM channels in GIST is poorer than that for those without VM.