<b><i>Background/Aims:</i></b> The annual incidence of pancreatic neuroendocrine tumors (PanNET) has been estimated to be around 0.8/100,000 inhabitants. The aim of this study was to determine the frequency of incidental histological diagnosis of PanNET in pancreatic specimen evaluation for a purpose other other than PanNET diagnosis. <b><i>Methods:</i></b> One thousand seventy-four histopathological examinations of pancreatic specimens performed in 3 centers in Italy were retrospectively reviewed. All cases with a main pathological diagnosis of PanNET were excluded. <b><i>Results:</i></b> An incidental associated diagnosis of PanNET was made in 41 specimens (4%). Among those 41 cases, 29 (71%) had a largest diameter &#x3c;5 mm (microadenoma), whereas the other 12 (29%) had a maximum size ≥5 mm (median diameter of the whole series = 3 mm, range 1–15). The association with a main diagnosis of intraductal papillary mucinous neoplasms (IPMN) was significantly higher for patients who had an incidental PanNET (<i>p</i> = 0.048). There was no association between incidental diagnosis of PanNET and age, gender, BMI, smoking habit, diabetes, and type of operation. <b><i>Conclusions:</i></b> The frequency of incidental histological diagnosis of PanNET is considerably high, suggesting that their real prevalence is probably underestimated. The present study suggests a possible correlation between the incidental occurrence of PanNET and IPMN.