Abstract: Insulinoma is one of the most common pancreatic endocrine neoplasm and is difficult to be detected by typical technology. Radionuclide imaging methods such as SPECT and PET have provided a new technology for insulinoma diagnosis with advantages of non-invasive, high sensitivity and specificity. Glucagon-like peptide-1 receptor(GLP-1R) is an attractive target for imaging due to its overexpression in insulinoma. Exendin-4, the agonist of GLP-1R, could specifically bind to the receptor. This paper reviews the progress of radionuclide-labeled Exendin-4 analogs in insulinoma imaging.