Vascular disorders of the gastrointestinal (GI) tract range from non-symptomatic lesions to acute life-threatening disorders. Generally, they can be classified as ischemic or bleeding, although this is often a superficial distinction with much overlap. Primary vascular disorders of the GI tract are assessed by pathologists at the time of biopsy or surgical resection, as well as at autopsy. Diagnoses requires a multidisciplinary approach, but pathology often plays a particularly important role in suggesting or confirming a diagnosis. Careful attention to pathologic specimens is important, as the distinguishing features of each entity may be subtle and difficult to appreciate. Likewise, patient management may differ significantly among conditions with overlapping diagnostic features. This chapter will provide a concise review of the diagnostic elements to consider in vascular disorders of the GI tract, and will discuss practical aspects that should help the pathologist to arrive at the best diagnosis for each case.