Small bowel tumors include adenocarcinomas, carcinoids, lymphomas, and sarcomas, as well as a variety of benign polyps, which should be excised to rule out malignancy. Although small bowel tumors are traditionally difficult to diagnose, a heightened index of suspicion should be combined with improved diagnostic techniques to increase yield and decrease delays in identification. The management of bioactive carcinoid tumors has rapidly advanced over the past year. Increasing experience with the stable somatostatin analogue octreotide has enabled regulation of hormonal secretion by these tumors both chronically and during acute "carcinoid crisis." In addition, early identification may be facilitated by the use of isotopically labeled variants of the compound. Although the development of sophisticated pharmacotherapeutic probes has improved the management of secretory small intestinal tumors, the prognosis for adenocarcinomas, lymphomas, and sarcomas still primarily reflects on the time of delay in diagnosis and awaits an improved understanding of the pathobiology of these malignant lesions.