The incidence of rectal neuroendocrine tumors (R-NET) increases, probably because of the colonoscopic colorectal cancer screening. R-NET represents about one third of all neuroendocrine tumors. They are localized at diagnostic in the majority of cases, metastatic forms count for 2 to 8% of tumors. The classic endoscopic aspect is a single yellow submucosal nodule. The metastatic prognostic mainly depends on the nodule size but also on histological factors as lymphovascular invasion, invasion of the muscularis, and a high histopronotic grade. R-NET less than 10 mm without poor prognostic factor should be removed endoscopically with negative resection margins and the patient does not require follow-up. At the opposite, R-NET larger than 20 mm needs scanographic extension assessment and carcinologic surgery. There is no consensual attitude for R-NET between 10 and 20 mm, an endoscopic resection is possible but a carcinologic surgery must be considered in the presence of poor prognostic factors.