Objective: Pancreatic neuroendocrine tumour (pNET) is a rare type of tumour with different malignant potential. Nowadays there is no universal approach for treatment of small and benign-looking pNETs throughout the world. Methods: There were 137 patients with pNETs surgically treated in our department between 2007 and 2017. Most of them were female - 96 cases with median age 42 years old. Organ-preserving procedures (OP) were performed in 44 (32%) cases and were compared with standard procedures 93 (68%) cases. Results: Main intraoperative characteristics were comparable in groups. There was significantly less estimated blood loss volume in the OP group: less than 1 dL. Postoperative length of stay and drainage placement time were less in the OP group. There were less pancreatic fistulas and no delayed gastric empties in the OP group. 90-day postoperative mortality rate was the same in both groups: four cases of severe postoperative pancreatitis with acute respiratory distress syndrome. Conclusion: As the “wait-and-see” policy can be not useful due to uncontrolled disease progression, choice of organ-preserving treatment first can become the first line of decision taking in small benign pNETs. Our experience shows that organ-preserving treatment is more comfortable for the surgeon and for the patient. However, it is not the universal position. The long-term survival data still has to be estimated.