Introduction: Despite low incidence rate, gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the digestive tract. Worldwide and in the US, the epidemiology of GIST over last 2 decades has not been addressed in the era with most advances in endoscopic techniques. Therefore, we explored national sample to: 1. Evaluate the trend of GIST in the US; 2. Determine the changes in annual percent changes (APC) of the incidence rates of GIST by age, gender, race, location of primary tumor, and tumor size. Methods: We utilized the National Program of Cancer Registries (NPCR), and Surveillance, Epidemiology, and End Results (SEER) program to distinguish all cases of GIST diagnosed from 2001 to 2015. Cases of GIST were identified using site and size from the ICD for Oncology, (ICD-O-3) codes: 8936/2 and 8936/3. The age adjusted incidence and APC were calculated. Results: A total of 39,035 cases of GIST were identified. Of which 33,066 cases were ≥50 years. Forty-eight percent were females, 74.3% Caucasians, 19.2% African Americans, and 6.5% others. Significant increase in APC was noted in the entire cohort (APC of 3.6 [2.7, 4.4]). The APC has significantly increased in both males and females but with the largest rise in the females ≥50 (APC 4.2 [3.2, 5.2]). Similarly, all ethnicities experienced a significant rise in APC as well with the largest rise in African Americans ≥50 (4.8 [3.7, 6.0]). Increasing incidence of GIST was noted in across stomach, small intestine and rectum with the largest rise in gastric GISTs. By tumor size, the incidence rate has significantly increased for tumor 10cm in size. Conclusion: Overall GIST incidences are significantly increasing every demographic but greatest increases are seen in females and African Americans in the US. The observed trends for smaller tumors could be attributed to technological advances and increased provider recognition of GISTs. Incidences of larger GISTS (>5 cm), associated with higher malignant potential and risk of recurrence, have remained stable.