Abstract: Pancreatic neuroendocrine neoplasm (pNEN) is a relatively rare type of pancreatic tumor, and its incidence has been on the rise in recent years. The treatment of pNEN with liver metastasis needs comprehensive consideration of its pathological grade, tumor stage, liver metastasis burden, and extrahepatic metastasis, etc. On the basis of comprehensive evaluation, multidisciplinary team is needed to formulate the best diagnosis and treatment plan, and the main goals are to control tumor growth, reduce tumor burden, control excessive hormone secretion and related complications, and prolong patient survival. Surgery is an effective treatment method for pNEN with liver metastasis, which helps to improve the prognosis of patients. Based on literature review and our experiences, this article elaborated the current major issues of concern, to provide a guide for surgical treatment of pNEN with liver metastasis.