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[Display omitted] • Metabolic disorders have long been associated with an increased risk of developing different types of cancer. • Obesity and diabetes represent a recognized risk factor for site-specific GEP-NETs, particularly pNETs. • On the other hand, GEP-NETs could also promote metabolic disorders, particularly diabetes, through different mechanisms. • Metabolic control reduces the aggressiveness and improves the outcomes of GEP-NETs and the anti-cancer therapies efficacy. • Diet, lipid-lowering drugs and metformin should be 1st-line therapies in GEP-NETs patients withmetabolic imbalances. Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a heterogeneous group of malignancies derived from neuroendocrine cells that can occur anywhere along the gastrointestinal tract. GEP-NETs incidence has been steadily increasing over the past decades, in parallel with the increasing incidence of the metabolic syndrome (MetS). It is not yet fully known whether the MetS components (such as obesity, dyslipidemia and type 2 diabetes) could be involved in the etiology of GEP-NETs or could influence their outcomes. In this review, a panel of experts of the Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Endocrinology (SIE), and Italian Society of Pharmacology (SIF) provides a critical view of the experimental and clinical evidence about the association of GEP-NETs risk, outcomes, and therapies with the metabolic disorders typical of MetS. The potential therapeutic strategies for an optimal management of patients with both GEP-NETs and MetS are also discussed. [ABSTRACT FROM AUTHOR]