compliance with surveillance recommendations for foregut subepithelial tumors is poor results of a prospective multicenter study background american gastroenterological association guidelines recommend performing eus to characterize subepithelial lesions sels discovered on upper endoscopy egd followed by surveillance if no highrisk features are identified however limited data are available on the impact of and compliance with surveillance recommendationsobjective to determine the natural history of sels30 mmlimitations short followup duration compliance was a secondary aimconclusions during a median followup of 30 months growth in size was observed in 25 of small foregut sels however change in size was minimal and only 1 patient was referred for surgery based on surveillance eus findings compliance with surveillance recommendations is poor with fewer than 50 of patients undergoing surveillance eus as recommended