【Abstract】 Objective To explore the clinicopathological risk factors closely related to the prognosis of patients with rectal stromal tumors, and to establish the pathological factor score and analyze its predictive value for the tumorfree survival of rectal stromal tumors. Methods From January 2006 to December 2014, 51 cases of rectal stromal tumor were collected from Changhai Hospital Affiliated to Naval Military Medical University. According to the risk classification standard, the risk of tumor was divided into extremely low risk, low risk, medium risk and high risk. The extremely low risk group and the low risk group were set as the low risk group, the medium risk group and the high risk group as the high risk group. The basic clinical data, pathological data and followup data were collected for retrospective analysis. Cox single factor analysis was used to find the prognostic factors of tumor free survival. Cox multivariate analysis found independent prognostic factors and used Akaike information criterion (AIC) to find the optimal model. The survival time of patients with rectal stromal tumor was evaluated according to the optimal model, i.e. clinicopathological factor score. Results The results of Cox single factor analysis indicated that the high risk grade and the high preoperative neutrophil to lymphocyte ratio (NLR) were the factors influencing the poor prognosis of patients with rectal stromal tumor. Further Cox multivariate analysis showed that high risk grade and high NLR were independent factors of poor prognosis. According to the optimal model fitted by AIC, the tumor free survival rate in the low risk group was significantly higher than that in the high risk group (P＜0.05), and the cancer free survival rate in the high NLR group was significantly lower than that in the low NLR group (P＜0.05). Conclusion The high risk grade and NLR are closely related to the tumorfree survival of patients with rectal stromal tumor. Clinicopathological factor score can effectively evaluate the tumorcfree survival of patients with rectal stromal tumor.