The treatment of pancreatic neuroendocrine tumor combined with liver metastasis includes both surgical and non-surgical treatments, and early management can slow down the progress of the disease. Neuroendocrine tumors are a series of tumors originating from neuroendocrine organs or cells in the human body, which can occur in any part of the body, most commonly in the digestive and respiratory systems. Pancreatic neuroendocrine tumors (PanNET) are clinically rare and usually malignant. PanNET can be categorized as limited stage, critically resectable, locally progressive, and advanced metastatic based on staging and the ability to be surgically resected. Whether metastatic PanNET can be directly surgically resected still requires comprehensive evaluation of the site of the primary focus, biological behavior and tumor load. 1. Non-surgical treatment: Systemic drug therapy (e.g., targeted drugs, chemotherapeutic agents, etc.) is the main means to control the disease progression of metastatic PanNET and reduce the tumor load; 2. Surgical treatment: Surgical resection can be preferred for some liver metastatic PanNET, including radical resection and tumor reduction surgery. According to some studies, hepatic metastatic PanNET with tumor reduction surgery (resection of 70%~90% of tumor load) is beneficial to patients’ prognosis. Pancreatic to hepatic neuroendocrine tumors need to be comprehensively examined before treatment, according to the examination results of symptomatic treatment, and at the same time to give patients good care.