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Objective To summarize the clinical manifestations, imaging features, laboratory findings, pathological characteristics, treatment modalities, and prognosis of primary hepatic neuroendocrine neoplasms (PHNEN). Methods A retrospective analysis was conducted on the clinical data of 7 patients with PHNEN admitted to The Affiliated Hospital of Qingdao University between June 2015 and July 2023. Data collected included clinical manifestations, imaging features, and laboratory results. Results The cohort consisted of 4 males and 3 females, with a median age of 54 (53, 64) years. Six patients were asymptomatic, with lesions discovered incidentally during physical examinations, one patient presented with an upper abdominal mass. Six patients had solitary tumors (3 in the left lobe, 3 in the right lobe), and one patient had multiple tumors involving both lobes. Pathologically, there were 5 cases of neuroendocrine tumors (NET), including 4 G2 grade and 1 G1 grade, and 2 cases of Small cell neuroendocrine carcinoma (SCNEC). Arterial phase enhancement was observed in 3/3 patients undergoing contrast-enhanced CT and in 3/4 patients undergoing contrast-enhanced MRI. Immunohistochemical staining showed positivity rates of 7/7 for Syn, 5/5 for CgA, and 5/5 for CD56. Six patients underwent radical surgical resection, while one patient only underwent intraoperative biopsy due to excessively large tumor size. The median follow-up time was 11 (3, 102) months. Among the six patients who underwent radical resection, four showed no recurrence, one recurred at 8 months postoperatively, and one recurred at 96 months postoperatively. These two patients received no further treatment after recurrence and died 2 months and 6 months later, respectively. The patient who only underwent biopsy died 3 months postoperatively. Conclusion PHNEN lacks specific clinical manifestations, imaging findings, and laboratory test results. Definitive diagnosis relies on pathological examination. Radical surgical resection is an effective treatment.