Twenty-one patients with primary gastrointestinal sarcomas underwent surgery at the University Clinics of Hamburg from 1970 to 1990. Main symptoms were gastrointestinal bleeding and abdominal pain. All but two tumors were classified as leiomyo-sarcomas. Seven sarcomas were located in the stomach, two in the duodenum, eight in the small and four in the large intestine or rectum. Seven patients presented lymph node and/or distant metastases. Complete resection was possible in 71% of the cases. Six patients received chemotherapy for metastatic disease. Five of the respective tumors showed progression under therapy, while the sixth patient had a complete remission of 55 months by the end of the study period. The mean survival time was 57 months and the five-year survival rate 46%. In contrast to literature data, tumor grade was not the most important prognostic factor in this series, but rather regional lymph node metastasis and local recurrence, predicting poor outcome.