In this article, we have focused on the evolving face of neuroendocrine tumors, newer approaches to their diagnosis and localization, the importance of sophisticated immunohistochemistry, tracer scanning, and the role of peptide therapy in the management of the symptom complex as well as the tumor. With recent expansion in our understanding of the pathophysiology of these tumors have come new and innovative approaches to their management. There is, however, much that remains unsolved and that requires diligent research and evaluation if we are ultimately to include neuroendocrine tumors among the curable cancers.