Introduction: Gastrointestinal neuroendocrine tumors (GI NETs) represent 1–2% of malignancies arising in the digestive tract, and the incidence has increased in recent years due to greater use of diagnostic tools. However, institution-level patterns in GI NET case counts and survival remain undercharacterized.

Objective: This study aims to evaluate demographic and site-specific case count patterns and survival outcomes across a large multi-hospital healthcare system.

Methods: We conducted a retrospective cohort study of 1,813 patients diagnosed with GI NETs across MedStar Health from November 2012 to September 2024. Cases were identified using the International Classification of Diseases (ICD) codes. Tumors were categorized as benign, malignant, or mixed coding history based on ICD patterns. Case counts were stratified by sex, race, age, and tumor site. Survival analyses used unadjusted Kaplan–Meier curves and log-rank tests to compare tumor categories and six anatomical sites (appendix, large intestine, pancreas, rectum, small intestine, stomach).

Results: GI NET case counts increased over the study period, with higher counts observed among women and individuals aged 51–74 years. Most diagnoses occurred in White (45.8%) and Black (40.7%) patients. Small-intestinal and rectal NETs were the most frequently identified. Survival patterns showed that female sex, White race, younger age, and benign tumors were associated with the most favorable outcomes. Among all anatomical sites, rectal NETs demonstrated the highest long-term survival.

Conclusion: This large institutional study highlights meaningful demographic and site-specific variation in GI NET case counts and descriptive survival patterns. These findings underscore the need for future research addressing access-related and sociodemographic contributors to GI NET outcomes.