Pancreatic neuroendocrine neoplasms (pNENs) are rare heterogeneous tumors with various malignant potentials. With the widespread application of cross-sectional imaging, the frequency of diagnosis of asymptomatic non-functional pancreatic neuroendocrine neoplasms (NF-pNENs) is increasing annually. However, there are still significant challenges in clinical diagnosis, delayed surgical treatment, and other aspects. Deepening the understanding of NF-pNENs can help improve the clinical diagnostic rate and subsequently implement timely and effective treatment. In this review, the authors discuss the controversial issues in the clinical diagnosis and surgical treatment of NF-pNENs, aiming to provide reference for clinical practice.