Background: We reviewed our experience with pancreatectomy for NE tumors to determine outcomes after complete (R0/R1) or incomplete (R2) resection and compare them to patients in whom resection was not attempted (NR). Methods: Data were reviewed for all patients presenting with NE tumors of the pancreas between 1990 and 2005. Survival curves were created using the Kaplan-Meier method and compared by log-rank analysis. Multivariate regression analysis was completed using Cox Proportional Hazards Analysis to identify risk factors for poor survival in patients undergoing resection. Data are reported as median overall survival. Results: Of 120 patients presenting with NE tumors of the pancreas, 65 (54%) had functional tumors, 13 of which had MEN1. Resection was undertaken in 83: distal pancreatectomy in 41, pancreaticoduodenectomy in 27, enucleation in 14, and central pancreatectomy in one. Survival was significantly longer if resection was undertaken (91 months vs. 24, p<0.001). R0/R1 resection was accomplished in 64 (77%) and resulted in lower perioperative mortality (1.5% vs. 21%, p=0.01) and longer survival (112 months vs. 24, p<0.001) compared to R2 resection. Survival was the same between patients undergoing R2 resection and those in which resection was not attempted (figure). Factors predictive of decreased survival by multivariate analysis were age, moderate/poor differentiation, R2 resection, and malignant histology. Conclusion: Long-term survival is possible following complete resection for NE tumors of the pancreas. However, cytoreductive operations resulting in incomplete tumor removal carry significant perioperative mortality without long-term survival benefit and should be discouraged.