Objective To investigate the clinicopathological and prognostic characteristics of intestinal inflammatory myofibroblastic tumours （IMT） in middle?aged and elderly patients. Methods The clinical， pathological morphology， immunophenotype and follow?up results of 5 cases of intestinal IMT in middle?aged and elderly patients were retrospectively analyzed. Results 4 cases of IMT occurred in the right half colon and 1 in the ileum. Most patients （3/5） had a history of intestinal injury， starting the digestive tract symptoms and increased leukocytes. The tumor tissue was composed of fusiform myofibroblasts and fibroblasts arranged in storiform pattern， with an infiltrative growth pattern， accompanied by a large number of lymphocytes and plasma cells infiltration， collagen formation and myxedema. One case was atypically large and deformed. Immunophenotype： vimentin （5cases）， SMA （5 cases）， desmin （3 cases）， ALK （3 cases）， CK （2 cases） were positive. Caldesmon， CD34， β?catenin， MC， CD117， DOG1， S?100， BCL?2， CD99， CD68 were negative， and Ki?67 proliferation index was 1.28% to 10.01%. All the 5 cases underwent complete tumor resection and were followed up for 48.5 to 133 months. Among them， 1 patient aged 83 was considered to have tumor recurrence 27 months after surgery. The other patient survived 122 months without tumor and died of other causes. All the others survived without tumor and were in good condition. Conclusion （1） Intestinal IMT in the middle?aged and elderly people in this group was more common in the right half colon， and most of them had a history of intestinal injury， first gastrointestinal symptoms and elevated white blood cells； （2）Vimentin and SMA were positive at the same time， and ALK was more positive； （3）4/5 patients had good surgical resection， and 1/5 patients could relapse 2 ~ 3 years after surgery； old age， ALK?positive， Ki67 up to 10%， atypia may be an important risk factor for intestinal IMT recurrence in the elderly， of which ALK?positive patients may have a recurrence risk of 1/3.