Pancreatic neuroendocrine neoplasms (pNENs) are a group of tumors with heterogeneous clinical characteristics and complex nature. Though the incidence of pNENs is low, all pNENs are considered to have a potential to be malignant. The histological grading is important to the selection of treatment and prognosis evaluation. If the pathological grading can be evaluated before operation, it will be helpful to the selection of treatment strategy and prognosis evaluation. With the rapid development of artificial intelligence (AI), the precision image analysis technology represented by deep learning, image group and texture analysis technology can analyze and interpret the image representation information more deeply, which is related to pathological grade. This paper reviews the current status and recent advances of the application of AI medical imaging technology in grading pNENs.