Abstract The landscape of treatment options in NET has changed in the last 5 years. Novel targeted drugs have been introduced and approved for distinct types of NET. Furthermore, with the first randomized trial on 177Lu-DOTATATE peptide receptor targeted therapy (PRRT) in midgut NET, not only approval of this treatment is awaited but also its more widespread use. Techniques and choices of radionuclides have changed over time as well as imaging tools. Recognition of well differentiated NET G3 within the group of neuroendocrine neoplasms G3, has widened the spectrum of chemotherapeutic drugs used in this field. Even more it has become important to provide recommendations for daily clinical practice on how to safely use novel drugs, chemotherapeutic agents and PRRT. The updated ENETS consensus guidelines for standard of care in neuroendocrine tumors (NET) provide a tool to accurately assess the diagnosis of NET and provide practical recommendations for the use of surgery, and the different systemic therapeutic options that are available for the management of NET.