Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms arising from interstitial cells of Cajal with predominant localization in the stomach. Modern surgical management of localized gastric GISTs favors minimally invasive organ-sparing techniques ensuring total resection (R0) and reducing recovery time. This article presents laparoscopic submucosal excision of gastric antral GIST in a 63-year-old female with multiple comorbidities. A 4-cm tumor arising from muscular layer was resected without mucosal disruption. Postoperative period was uneventful, and histological examination confirmed R0 resection with low proliferative activity (Ki-67 3%). No recurrence was detected throughout 20 months. Analysis of literature data highlights the advantages of submucosal approach for small (≤5 cm) extramural gastric GISTs, including technical simplicity, lower intraoperative risks, and preserved organ function. Key selection criteria include tumor location (anterior wall/greater curvature), growth from muscular layer and no adhesions. This case supports feasibility of laparoscopic submucosal resection in carefully selected patients. Further multiple-center studies are needed to standardize this technique and evaluate long-term outcomes.