Background/ObjectiveEvidence on the efficacy and safety of minimally invasive treatment for insulinoma has increased over the past decade to the point of becoming a recommendation in clinical practice guidelines for the management of this type of neuroendocrine tumor.Case ReportWe describe the case of an elderly male patient with multiple comorbidities and recurrent isolated insulinoma of 3.7 x 3.5 cm involving the uncinate process of the pancreas and contacting the spleno-mesenteric confluent many years after first resection, in whom, after refusing surgical management, was performed a successful arterial embolization of the pancreatic tumor.DiscussionWhen addressing this pathology, it is common to encounter patients who are not candidates for surgical management, either due to the presence of comorbidities, the location of the tumor in relation to vascular structures, or refusal of the intervention. Therefore, it is important to be aware of the different therapeutic options in localized and metastatic disease.ConclusionMinimally invasive procedures are positioned as a effective alternative for the treatment of the hormonal overproduction in patients with insulinoma.