The medical management of metastatic endocrine tumors, such as malignant insulinoma, adrenal carcinoma, and malignant carcinoid, involves the use of both anticancer and antihormonal chemotherapy. The former is directed against the primary tumor and its metastases, while the latter offers palliation through the inhibition of synthesis, release, or direct cellular action of the specific secretory product. The current clinical results with the use of streptozotocin in malignant insulinoma, and o,p′DDD in the treatment of adrenocortical carcinoma are reviewed.