Gastric masses have a broad differential that ranges from benign to malignant, with a similarly wide range of presentations, including life-threatening bleeding and perforation to incidental discovery. Nearly all symptomatic gastric masses warrant referral to a surgeon for evaluation and management, with the urgency of referral depending on associated symptoms and objective findings, including laboratory studies and imaging tests. Certain asymptomatic gastric tumors may safely be surveilled by endoscopy or imaging. Workup of a gastric mass to inform appropriate management requires tissue diagnosis and is typically obtained on upper GI endoscopy by either a surgeon or gastroenterologist. This chapter outlines the relevant history, clinical examination, and workup that informs the need for surgical referral for gastric masses. Urgency of surgical referral and clinical scenarios in which surgical referral are not needed is also reviewed.