Gastric inflammatory fibroid polyps (GIFPs) are rare benign subepithelial lesions (SELs). They frequently present as an indeterminate SEL after additional diagnostic modalities have failed to yield a diagnosis. In the absence of standard management pathways, we sought to evaluate the diagnostic and therapeutic role of endoscopic resection (ER) for GIFPs.

We retrospectively analysed a prospectively maintained database at a tertiary referral centre. Consecutive patients with histologically confirmed GIFPs who underwent endoscopic resection (ER) between November 2013 and March 2025 were included. The primary outcomes were en bloc resection and R0 excision. Secondary outcomes included adverse events, recurrence, and resolution of anaemia.

Seventeen patients (median age 72 years, IQR 70–79) were identified. En bloc resection was achieved in all (100%), with R0 resection in 35%. Pre-resection EUS correctly identified submucosal origin in 50%, and histology suggested GIFP in only 9%. There were no perforations or serious adverse events. One delayed bleed (6%) was managed conservatively. Among patients presenting with anaemia, 71% demonstrated resolution post-ER. No recurrence was observed during follow-up, including in margin-positive cases.

ER provides both diagnostic certainty and definitive treatment for GIFPs, which generally present as an indeterminate gastric SELs. Given the poor accuracy of pre-resection testing and absence of recurrence, ER should be regarded as the preferred first-line strategy, with routine post-resection surveillance generally unnecessary once diagnosis is confirmed.