Background: Gastrointestinal (GI) malignancies demonstrate marked geographic variation. The Kashmir Valley is recognized as a high-risk region for upper GI cancers, yet data from district-level hospitals remain scarce. Objectives: To describe the demographic, endoscopic, anatomical, and histopathological profile of GI malignancies presenting to District Hospital Kulgam and to compare findings with published literature from Kashmir, India, and abroad. Methods: A retrospective case series of biopsy-confirmed GI malignancies admitted from January 2023 to march 2024 was conducted. Demographic variables, lesion location, endoscopic/colonoscopy gross morphology, and histopathology were analyzed. Results: A total of 23 patients were included. Mean age was 58.2 years, with a male predominance (M:F = 2.8:1). Upper GI malignancies accounted for 83% of cases, with gastric adenocarcinoma being the most common. Ulcero-proliferative lesions were the predominant endoscopic finding. Conclusion: GI malignancies in Kulgam predominantly affect older males and are largely upper GI in origin, mirroring patterns reported from Kashmir and other Asian high-risk regions.