The most effective treatment of the neuroendocrine tumors of the alimentary tract is their surgical removal. Inzulinomas are easy removable, usually by enucleation. They are easy localized on contrast CT scan, they are small and benign lesions. Gastrinomas are usually localised outside the pancreas, mostly in the gastrinomas triangle. The surgeon usually needs the preoperative ultrasound. As soon as they are localized and without metastases, removal is not difficult. Vipomas require preopreative rehydratation of the patient, they are removable by enucleation or pancreatic resection. After removal of the vipoma the symptoms promptly disapeare. Glucagonomas and somatostatinomas are rarely removable for their large size and early metastatic spread. Carcinoid is easy removable by appendectomy or bowel resection, in case of metastatic carcinoid, debulcisation is justified. In case of MEN - 1 syndrome the first step of surgical treatment is subtotal parathyreoidectomy, subsequently removal of pancreatic inzulinoma or gastrinoma is performed.