Background: The published data on accuracy of Endoscopic Ultrasound to detect pancreatic neuroendocrine tumors (PNT) has been varied. Detection of PNT is critical from a therapeutic stand point.Aim: To evaluate the accuracy of EUS in detecting PNT. Method:Study Selection Criteria: Only EUS studies confirmed by surgery or appropriate follow-up were selected. Only studies from which a 2 X 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Data collection & extraction: Articles were searched in Medline, Pubmed, Ovid journals, Cumulative index for nursing & allied health literature, International pharmaceutical abstracts, old Medline, Medline nonindexed citations, and Cochrane Central Register of Controlled Trials & Database of Systematic Reviews. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. 2 X 2 tables were constructed with the data extracted from each study. Statistical Method: Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. Pooling was conducted by both Mantel-Haenszel method (fixed effects model) and by the DerSimonian Laird method (random effects model). The heterogeneity among studies was tested using Cochran’s Q test based upon inverse variance weights.Results: Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (N = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNT was 87.2% (95% CI: 82.2 - 91.2). EUS had a pooled specificity of 98.0% (95% CI: 94.3 - 99.6). The positive likelihood ratio of EUS was 11.1 (95% CI: 5.34 - 22.8) and negative likelihood ratio was 0.17 (95% CI: 0.13 - 0.24). The diagnostic odds ratio, the odds of having anatomic PNT in positive as compared to negative EUS studies was 94.7 (95% CI: 37.9 - 236.1). All the pooled estimates calculated by fixed and random effect models were similar. SROC curves showed an area under the curve of 0.94. Begg-Mazumdar bias indicator for publication bias gave a Kendall's tau value of 0.31 (p = 0.16), indication no publication bias. The p for chi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. Conclusions: EUS has excellent sensitivity and specificity to detect PNT. EUS should be strongly considered for evaluation of PNT.