Ever since their first description over a century ago, intestinal carcinoid tumors have remained equally fascinating and perplexing. The initial reports of a benign, “cancer-like” growth that can result in distinctive hormonal symptoms are largely true today. However, the term “carcinoid” belies the fact that these are malignancies that can be associated with significant morbidity and mortality. Of concern is their increasing incidence in the population, and a nearly 5-fold increase has been documented over the past 3 decades.