Canine insulinomas are the most common pancreatic tumours in dogs. They are considered to be malignant in more than 95% of the cases because they almost always tend to metastasise. However, with a combination of surgery and medical management median survival times of 2 years have been reported with some dogs even surviving for 7 years. This lecture will provide you with a summary and update of the current recommendations for the diagnosis, treatment and prognostication of canine insulinomas. It will also highlight ongoing clinical studies, aimed to further improve the clinical outcome of dogs with insulinomas.