Objective To compare different treatment methods for patients with gastric calculi and provide data support for clinical treatment. Methods A total of 197 patients diagnosed with gastric calculi by gastroscopy at the General Hospital of Ningxia Medical University and Cardio-Cerebrovascular Disease Hospital of General Hospital of Ningxia Medical University from July 2013 to January 2024 were enrolled. The study collected general information and other data of the patients， and divided them into groups based on the selected treatment method using a real-world research approach. The subjects were divided into four groups： drug conservative treatment group， endoscopic homemade snare treatment group， disposable snare treatment group， and stone fragmentation treatment group. Statistical analysis was performed using one-way analysis of variance. Results Gastric calculi were more common in men， with an average age of （55.45±14.21）. 85.3% of the patients had a history of eating persimmon， 86.3% had ulcers， and 65.9% were located in the gastric angle. The self-made snare group had the lowest treatment cost， while the stone fragmentation group had the highest. There was no significant difference in the remission time of clinical symptoms among the three endoscopic treatment methods. The self-made snare had the highest patient satisfaction， but the drug combined with carbonated beverage group had the longest remission time of clinical symptoms and the lowest patient satisfaction. The frequency and duration of endoscopic treatment of dark green gastric stones were significantly higher than those of mottled and golden yellow gastric stones. Conclusion When treating patients with gastric stones， it is important to consider the size and color of the stone， as well as the patient's preferences. Patients should be fully informed about their condition and the advantages of different treatments. For patients with larger stones （about 5 cm）， endoscopic snare treatment is recommended as the first choice.