Review is devoted to current problems of classification, diagnosis and treatment of pancreatic neuroendocrine tumors. According to modern views, all pancreatic neuroendocrine tumors over 5 mm or those followed by clinical manifestations are biologically malignant. It is shown that certain proportion of pancreatic neuroendocrine tumors are non-functioning. Diagnosis of neuroendocrine tumors is highly difficult issue. Currently, surgery is only radical and adequate approach for functioning pancreatic tumors. Need to optimize diagnostic and surgical algorithm for improvement of outcomes in these patients is emphasized.