Islet cell tumors are rare pancreatic or peripancreatic neoplasms that produce and secrete hormones to a variable degree. Neuroendocrine tumors of the pancreas can occur sporadically or in association with multiple endocrine neoplasia type 1 (MEN I). Biologically active neuroendocrine tumors produce early symptoms and are often difficult to diagnose owing to their small dimensions, whereas biologically inactive forms are often large and sometimes found by chance. Imaging has a major role in the preoperative localization of the primary tumor and detection of metastases, providing an anatomic substrate whereas it plays a primary role in the regional staging of these neoplasm, for which surgery is the first and essential therapeutic approach. Several techniques are available including computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound, intraoperative ultrasound, somatostatin receptor scintigraphy, and arterial stimulation with venous sampling; each with unique advantages and certain limitations. Recent technical advances in Multidetector CT, and dynamic MRI using breath hold sequences have improved the sensitivity of these modalities markedly.