Local resection of duodenal papillary neoplasm has the advantages of small trauma, few complications and retaining the normal function of digestive tract. While this surgical procedure is not widely applied because of high demand of surgical techniques, difficulty in the management of complications and its efficacy still needs the verification of evidence based medicine. From January 2000 to June 2012, 4 patients received local resection of duodenal papillary neoplasm at the Renji Hospital of Shanghai Jiaotong University. All patients were confirmed as with duodenal papillary neoplasm by endoscopic retrograde cholangiopancreatography, and the diameters of the tumors were under 1 cm. The results of duodenal papillary biopsy showed that 3 cases were with hyperplasia and 1 case with adenocarcinoma. Lymph node metastasis or distal metastasis was excluded by computed tomography and magnetic resonance imaging preoperatively. The results of postoperative pathological examination confirmed that 1 case of duodenal papillary adenoma and 3 cases of duodenal papillary adenocarcinoma were with negative  margin and no metastasis in the hepatoduodenal ligament was detected. There was no complications except 1 case of pancreatic leakage. There was no recurrence during a follow up period of 3-24 months. Strictly abiding the indications and technical manual of local resection of duodenal papillary neoplasm is a key point to acquire good clinical effect.