<p>Insulinoma is the most common functioning pancreatic neuroendocrine tumour. At the time of diagnosis its dimensions are small, and it shows a benign behaviour in most cases. Emerging evidence in the literature is demonstrating that minimally invasive treatments can be effective, both in controlling hypoglycaemic symptoms and in achieving a radiologic response, with lower rates of periprocedural complications compared to surgical resection. Endoscopic ultrasound (EUS) is a diagnostic technique that enables the visualisation of even small pancreatic lesions and allows for tissue sampling for histopathological characterisation. EUS guidance is also used for radiofrequency ablation (RFA) of pancreatic lesions using dedicated needles. In recent years, this approach has been used, in highly specialised centres, in the treatment of patients who are poor surgical candidates or who refuse surgery. However, promising results suggest that its application could also be extended to patients who are suitable for surgical intervention. Our review summarises the results of the main studies on the efficacy and safety of EUS-guided RFA in the treatment of pancreatic insulinoma, highlighting the advantages and limitations of this technique in clinical practice.</p>