Lecture : OBJECTIVE To evaluate the safety and oncologic efficacy of minimally invasive surgery (MIS) in comparison with open surgery (OS) in the treatment of right-sided and left-sided non-functioning pancreatic neuroendocrine tumors (NF-PNETs). BACKGROUND There is no sound evidence for the safety and efficacy of MIS for NF-PNETs according to tumor location. METHODS Data of patients who underwent curative intended surgery for NF-PNET from August 1991 to July 2017 were collected from 14 institutions. Short-term outcomes and long-term prognosis were analyzed with inverse probability of treatment weighting method using the propensity score. RESULTS A total of 904 patients were enrolled (OS, n=510; MIS, n=394). After matching analysis in each tumor location, no differences were noted in resection margin, intraoperative blood loss and postoperative complication including pancreatic fistula. However, MIS was associated with longer operation time than OS (318.9 vs. 401.9 min, p<0.001) in right-sided tumors and shorter postoperative hospital stay (13.0 vs. 8.9 days, p<0.01) in left-sided tumors. The disease-specific and disease-free survival rates of MIS were equivalent or significantly higher compared with OS in right-sided and left sided tumors. In the multivariate analysis, the surgical approach (OS vs. MIS) did not affect the disease-free survival in both sides. CONCLUSION MIS had comparable short-term outcomes with OS except longer operation time in right-sided NF-PNETs and did not compromise the oncologic outcomes in right-sided and left-sided NF-PNETs. These findings suggest that MIS can be safely applied in selected patients with localized NF-PNETs regardless of tumor location.