Abstract: Pancreatic neuroendocrine tumors are a group of rare neoplasms originating from the neuroendocrine cells of pancreas. They can be classified into functioning or non-functioning groups according to hormone secretion. Due to the application of high-resolution imaging techniques, the incidence of incidental non-functioning pancreatic neuroendocrine tumors has been rising for decades. Although the optimal prognosis, non-functioning pancreatic neuroendocrine tumor are heterogeneous, and the complication morbidity is high. So controversy still exists for the choice of treatment approach. This article aims to summarize and analyze the progress and current controversy about the treatment of incidental non-functioning pancreatic neuroendocrine tumors, and discuss about the appropriate treatment choice for patients.