Small intestinal neuroendocrine tumors (SI-NETs) represent the most common neoplasms of the small bowel, with their incidence steadily rising. Surgery remains a cornerstone in the multidisciplinary management of SI-NETs, serving either a curative purpose—though complete (R0) resection is achievable in only about 20% of cases due to advanced disease at diagnosis—or a palliative role. Surgeons must consider the tumor’s hormonal activity, typical patterns of metastasis at presentation, and strategies for bowel-sparing procedures to prevent short bowel syndrome. This review summarizes current surgical indications and techniques, as well as perioperative and postoperative management strategies for SI-NETs.
