Objective To investigate the value of multi-slice spiral CT (MSCT) scanning in the diagnosis of gastrointestinal stromal tumor (GIST) in the elderly. Methods From May 2014 to May 2016,8 elderly patients with suspected GIST admitted in our hospital were subjected in this study. According to the National Institutes of Health (NIH) consensus classification system for GIST in 2002, the pathologically confirmed patients were classified into low risk tumor (n=35), risk tumor (n=17) and high risk tumor (n=11). CT and MSCT scanning were carried out on all the patients, and the results were compared with the pathological results for the diagnostic accuracy. SPSS 19.0 software was used to perform the statistical analysis. Results In the 98 cases of suspected GIST patients, 63 cases were verified as GIST by pathological diagnosis. MSCT showed the diagnostic accuracy of 88.89%(55/63) and specificity of 88.57%(31/35), and the positive predictive value of 93.33%(56/60) and negative predictive value of 81.58%(31/38) in the diagnosis of GIST. While, the diognostic accuracy was 79.37%(50/63), specificity was 71.43%(25/35), positive predictive value was 83.33%(50/60), and negative predictive value was 65.79%(25/38) in diagnosis of GIST by CT scanning. The diagnostic accuracy of MSCT was significantly higher than that of normal CT (P<0.05). Compared with risk and high risk tumor, the tumor diameter ≤5 cm(71.43%, 25/35), in regular shape (65.71%, 25/35), and uniform enhancement of low risk tumor (48.57%,17/35) had high proportion. Lesions mainly occurred in the stomach. There was no significant difference in CT values of plain, arterial, venous and delayed phase among the tumors of different risk degree (P>0.05). Conclusion MSCT is of certain application value in GIST diagnosis for the elderly. MSCT images can be used to judge the risk degree of GIST, be helpful for preoperative evaluation, and provide the basis for clinician to make treatment plan.