<h4>Objective</h4>To describe surgical indications, procedures and outcomes in patients operated for Zollinger-Ellison syndrome (ZES) in multiple endocrine neoplasia type 1 (MEN1) using a large nationwide cohort.<h4>Background</h4>Management of ZES in MEN1 remains controversial.<h4>Methods</h4>All patients with ZES diagnosed through the MEN1 AFCE/GTE network from 1985 to 2015.<h4>Results</h4>Among 233 ZES patients, 66 (28%) were operated for ZES-related gastrinomas. This evidence concerns the gene MEN1 and gastrin-producing neuroendocrine tumor.