Abstract: Objective To investigate the clinical features，diagnosis and surgical treatment of a series of 21 cases of insulinoma at a single medical center.Method Clinical data for 21 patients with insulinoma treated at the First Affiliated Hospital of Guangxi Medical University between December 2006 and October 2011 were retrospectively analyzed.Result A total of 18 of the 21 cases（85.7%） were benign，and the remaining 3 were malignant（14.3%）. All the tumors could be localized by ultrasound，computed tomography （CT）， magnetic resonance imaging（MRI） or a combination of these techniques. Surgical resection was the best treatment， and malig-nant cases were managed by transarterial hepatic chemoembolization（TACE） in addition to surgery. The most common postoperative complication was pancreatic fistula，which occured in 5 of 21 cases（23.8%）. Conclusion Preoperative imaging using multiple tech-niques can localize insulinomas，and intraoperative ultrasonography （IOUS） and surgical exploration may allow more precise localization of tumors.The optimal surgical approach depends on tumor location，size and characteristics，and should lead to minimal complications.

Key words: Insulinoma, Diagnosis, Surgical treatment