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Gastric dilatation-volvulus (GDV) syndrome is a life-threatening emergency and its physiopathology and treatment have been studied for decades. Despite ongoing research, the mortality rate is still high. The aims of this study are to describe the treatment and outcome of GDV patients treated from 2011 to 2024 at the veterinary teaching hospital of Grugliasco (Turin, Italy); to analyze risk and prognostic factors, comparing the obtained data with current literature; and to evaluate how patients’ management has changed over the years. The study included 130 dogs with a confirmed GDV diagnosis that underwent surgery. The data were extracted from the digital and hardcopy clinical record, combined with the imaging diagnostic software and an interview submitted to the dogs’ owners. The analysis showed the predominance (25.38%) of German Shepherd dogs, as well as of males (59.25%); among the latter, intact dogs were most represented (53.1%). Age between 5–10 years was most frequent in the examined population (54.69%). The surgical technique went through changes during the examined period: the belt loop has been abandoned in favor of the incisional gastropexy. The survival rate of GDV surgically treated dogs was 86.4%. Lactate blood concentration and splenectomy were not assessed as relevant prognostic factors.