It is imperative to seize the “golden rescue time” and implement new concepts and new skills in modern trauma rescue. Combining with the development background of smart medical image analysis, this topic focuses on surgical strategies and prognostic measures and studies a serious and difficult disease frequently occurring in middle-aged and elderly people: pancreatic neuroendocrine tumors. This article uses the comparative test method and sample collection method to collect the medical records of patients with neuroendocrine tumors diagnosed by pathology from July 2010 to January 2018 in the First Affiliated Hospital of X City and analyze the samples with gender and age. At the same time, routine tumor marker examination and the location of NEN in the digestive system were performed. The distribution analysis of EUS characteristics of neuroendocrine tumor mucosa in each site was performed after operation, and the analysis of survival-related factors was performed during postoperative follow-up. The experimental data showed that among the tumor causes, WHO tumor grade (
p
<
0.05
) and whether the surgical method was R0 resection (
p
<
0.05
) were associated with prognosis. However, factors such as gender, age, and functional status were associated with prognosis. It has successfully completed the subject of surgical strategy and prognosis of pancreatic neuroendocrine tumors based on smart medical image analysis.