Pancreatic neuroendocrine tumors (pNETs) are a relatively rare and highly heterogeneous type of neuroendocrine tumors, accounting for approximately 9.9% of malignant pancreatic tumors. However, due to their subtle early symptoms, most patients are diagnosed when distant metastases have already occurred. Therefore, early detection and intervention are particularly important. Currently, surgical resection remains the only curative option for pNETs. Although traditional treatment modalities such as radiation and chemotherapy can effectively kill tumor cells and improve patient survival, their treatment outcomes have always been unsatisfactory. In recent years, the emergence of new treatment modalities such as targeted therapy, immunotherapy, epigenetic drugs, and other approaches has benefited many patients who are not eligible for surgery and are insensitive to traditional treatment methods. Here, the authors discuss recent advances in the diagnosis and non-surgical treatment of pNETs.