Molecular imaging is changing diagnostic and treatment paradigms in patients with neuroendocrine tumors through its ability to non-invasively characterize disease, supplementing the traditional role of using imaging for localizing and measuring disease. For patients with metastatic disease, there is an increasing range of therapies but these must be individualized to the specific tumour subtype which well-differentiated indolent to poorly-differentiated aggressive phenotypes. Positron emission tomography (PET) is now able to characterize these subtypes through its ability to quantify somatostatin receptor cell surface (SSTR) expression with DOTATATE (GaTate) PET/CT, and glycolytic metabolism with fluorodeoxyglucose (FDG) PET, respectively. The ability to perform this as a whole body study is highlighting the limitations of relying on histopathology obtained from a single site. FDG PET/CT has emerged as a powerful prognostic tool superior to Ki,67. SSTR PET/CT enables selection of patients who are likely to benefit from somatostatin analogue therapy or peptide receptor radionuclide therapy. Progress continues with several newer generation radiotracers emerging for both SSTR imaging and radionuclide therapy.