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The overall incidence of rectal gastrointestinal stromal tumor (RGIST) has risen, but it remains a rare disease. Furthermore, tumor rupture is associated with poor prognosis. The present study reported a rare case of RGIST with indolent biological behavior. The biological behavior of this RGIST was analyzed and its malignant potential was evaluated using a guideline-based risk stratification assessment. The patient was diagnosed with a rectal tumor at the Third Affiliated Hospital of Qiqihar Medical University (Qiqihar, China) in April 2020 and a partial resection biopsy was then performed. This resection counts as a rupture. The biopsy confirmed RGIST and the patient refused further examination and treatment due to economic concerns. However, the patient survives with no tumor progression and metastasis until now, May 2022. In conclusion, based on the present case, tumor rupture in indolent RGIST is not necessarily associated with poor outcome. [ABSTRACT FROM AUTHOR]