Neuroendocrine neoplasms are a heterogenous group of tumors with distinct presentations based on the type of peptide hormone it produces. The majority of patients are asymptomatic with nonfunctional tumors incidentally found on imaging for other reasons. They are classified into well-differentiated and poorly differentiated tumors. Capable of arising in any organ, 60–80% are located in the gastroenteropancreatic region (GEP-NET) with a significant propensity to spread to the liver (NELM). Surgical resection remains the primary treatment option in patients with NELM amenable to surgery. As the majority present with extensive bilateral disease, cytoreductive surgery is a viable option with a trend in decreasing the debulking threshold to 70%. Intra-arterial and systemic therapies are indicated for symptomatic management, regional control, and improved progression-free survival in patients with inoperable disease due to locoregional anatomy or the risk of insufficient hepatic remnant. Liver transplantation has also been considered as an effective treatment option in select patients.