OBJECTIVE: To evaluate clinical outcomes, safety and survival measures of octreotide infusion pump (OIP) therapy in patients with metastatic neuroendocrine tumors (NETs) and refractory hormonal syndrome. DESIGN: A retrospective analysis was conducted using data from patients treated with OIP therapy at a single center. METHODS: Data on demographics, disease characteristics, biochemical profiles and treatment outcomes were extracted from electronic patient records. RESULTS: Eighteen patients with NETs and debilitating symptoms refractory to maximum approved doses of somatostatin analogs (SSTAs) were included. The cohort comprised 18 patients (12 males (67%) and six females (33%)) with a median age of 64.5 years (IQR: 49.5-71). The most common tumor site was midgut (72.2%), followed by pancreas (22.2%). Refractory carcinoid syndrome was the primary indication for initiation of OIP therapy in 15 patients and VIPoma in three. Most tumors were WHO grade 1 or 2 (89%), and liver metastases were prevalent (94% of patients). At presentation, the median 24-h urinary 5-hydroxyindoleacetic acid (5-HIAA) level was 421.5 μmoL/24 h ( CONCLUSION: OIP therapy is an effective treatment option for symptom control in patients with refractory NET-related hormonal syndrome. Randomized controlled trials are warranted to confirm these findings and assess long-term outcomes.