Pancreatic neuroendocrine tumor (pNET) is a rare tumor with relatively indolent biologic behavior compared with pancreatic adenocarcinoma. Even the incidence has been increasing in recent years, possible due to the routine health check-up, treatment guideline or proper surgical extents are still unclear. In this study, we intend to reveal appropriate treatment principles through Korean multi-institutional research. A total 951 patients from 14 tertiary referral hospitals were enrolled. The mean age was 54.0?2.3 years and 502 patients (52.8%) were female. Open procedure was done in 521 patients (54.8%) and 403 patients were underwent minimally invasive surgery (MIS). The mean tumor size was larger in open group (3.1?2.4 vs. 2.3?.5, p<0.001). In open group, most common tumor site was head (54.2%), otherwise, body and tail was the most common site (806%) in MIS group. R0 resection rate was similar in both group (93.1 vs. 93.8%, p=0.639). According to the WHO 2010 classification, 603 patients (63.4%) were G1, 251 patients (26.4%) were G2 and 56 patients (5.9%) were G3. Open procedures were more frequently performed in G3 (8.4 vs. 3.3%, p=0.003). The recurrence rates were 3.5% in G1, 19.9% in G2, and 49.1% in G3. In G1 group, 5 year disease-free survival (DFS) and overall survival (OS) rates were not different between open and MIS group (97.9 vs. 99.2%, p=0.108; 99.3 vs. 100%, p=0.161, respectively). In G2 group, 5 year DFS rate was similar (65.9 vs. 80%, p=0.067), but 5 year OS rate was better in MIS group (90 vs. 100%, p=0.027). There were no differences in 5 year DFS and OS rates in G3 group (35.9 vs. 67.7%, p=0.130; 51.7 vs. 61%, p=0.134, respectively). We will further analyze whether there is an actual difference in the survival outcomes between open and MIS group through propensity score matching.