Pancreatic neuroendocrine neoplasm (pNEN) is the most common neuroendocrine tumor in the digestive system. The heterogeneity of pNEN makes it difficult to summarize diagnostic and therapeutic strategies only based on clinical experience. Over the past 20 years, basic research on pNEN has been well developed, which in turn has promoted its theoretical system and diagnostic and therapeutic strategies, significantly improving the therapeutic efficacy of pNEN. In this paper, we review the development of basic research on pNEN in recent years and discuss its role in clinical diagnosis and treatment. On the one hand, the development of basic research can further reveal the nature of the differential biological behavior of pNEN and provide clinical reference; on the other hand, reference to the migratory basic research results in other tumor fields is also conducive to improving the clinical diagnosis and treatment level of pNEN.