Objective　Inflammatory　fibroid　polyps　(IFPs),　uncommon　benign　growths　in　the　gastrointestinal　tract,　currently　lack　standardized　treatment　protocols.　Our　investigation　sought　to　determine　crucial　clinical　indicators　for　therapeutic　decision-making　in　IFP　management.　Methods　We　conducted　a　retrospective　analysis　of　114　hospitalized　patients　from　The　First　Affiliated　Hospital　of　Fujian　Medical　University　and　Fuzhou　University　Affiliated　Provincial　Hospital　between　January　2015　and　April　2025.　Comprehensive　evaluation　included　patient　demographics,　lesion　features　(anatomical　distribution,　dimensions,　pathological　characteristics),　and　therapeutic　outcomes.　Statistical　approaches　incorporated　independent　sample　t-tests,　chi　2analyses,　and　generalized　estimating　equations　(GEE)　to　adjust　for　clustered　lesions.　The　threshold　for　surgical　consideration　based　on　lesion　size　was　established　through　receiver　operating　characteristic　(ROC)　evaluation.　Results　The　study　cohort　demonstrated　a　significant　female　predominance　(male-to-female　ratio　1:2.2),　with　gender　showing　a　significant　association　with　IFP　surface　morphology　(p　=　0.023),　median　patient　age　of　57.92　years　with　the　majority　asymptomatic　(69.3%),　anatomical　distribution:　gastric　(73.8%),　colorectal　(15.6%),　and　small　intestinal　(10.7%).　Absolute　surgical　indication　for　small　intestinal　IFPs　(vs　stomach,　OR　=　20.624,　p　＜　0.001).　Markedly　increased　surgical　likelihood　for　lesions　exceeding　1.65　cm　(area　under　curve　0.859;　82.6%　sensitivity,　74.7%　specificity).　Differential　complication　rates:　surgery　cohort　30.4%　vs　endoscopy　7.7%　(p　=　0.008).　Conclusions　Our　research　establishes　a　novel　dual-parameter　decision　framework　for　IFP　treatment:　anatomic-driven,　lesions　in　the　jejunum　and　ileum　warrant　primary　surgical　resection;　size-dependent,　1.65　cm　cutoff　optimizes　endoscopic　safety　for　gastric/colorectal　lesions.　This　discovery　provides　an　evidence-based　basis　for　individualized　diagnosis　and　treatment　of　IFP.