In 16 years, from 2007 to 2022, 568 patients affected by pancreatic NETs were referred to our Institution: 201 were metastatic at diagnosis; 11 had a mixed neuroendocrine/nonendocrine neoplasm; 13 had a high-grade neoplasm (NET G3/NEC/large-cell NET); 24 presented with functioning sporadic pancreatic tumors; 17 patients have a hereditary syndrome (15 MEN1, 2 Von Hippel–Lindau); 205 underwent surgery; 25 were lost to follow-up or declined to participate. The gene discussed is MEN1; the disease is neoplasm.