Objective: To investigate the influence of spleen preservation on prognosis of patients with pancreatic neuroendocrine neoplasms (PNEN) following distal pancreatectomy. Methods: The clinical data of 32 patients with PNEN undergoing surgical resection of the body and tail of the pancreas between February 2007 and July 2012 were analyzed retrospectively. Of the patients, 21 cases had combined splenectomy, and 11 cases had their spleen preserved. The postoperative survival of the two groups of patients was compared, and the prognostic factors for these patients were analyzed. Results: The postoperative follow-up ranged from 13 to 62 months, with an average of (41.86±5.14) months. The 1-, 3- and 5-year overall survival rate was 100%, 90.91%, and 81.82% in patients with spleen preservation, and was 90.48%, 80.95% and 76.19% in those having splenectomy respectively, and the postoperative survival in patients with spleen reservation was significantly superior than that in patients undergoing splenectomy (P<0.05). Univariate analysis showed that TNM stage, lymph node metastasis and nerve or vascular invasion, and splenectomy were related factors affecting the prognosis of the patients (all P<0.05), while multivariate analysis showed that only tumor TNM stage was the independent prognostic factor for the patients (P<0.05). Conclusion: Distal pancreatectomy with spleen preservation is beneficial for postoperative survival of patients with PNEN, but it does not independently affect the postoperative outcomes.