The case of a woman with recurrent Verner-Morrison syndrome associated with a multicentric and metachronously metastatic pancreatic islet cell tumor is described. Her original symptoms resolved after distal pancreatectomy and splenectomy for an islet cell carcinoma of the tail of the pancreas. Recurrent symptoms were associated with a raised plasma vasoactive intestinal polypeptide (VIP) level, an islet cell tumor in the neck of the pancreas, and liver metastases. After partial pancreatectomy and resection of the liver metastases, her symptoms resolved and plasma VIP level normalized. This case emphasized the potential role of resection in the management of the Verner-Morrison syndrome associated with a recurrent, metastatic vipoma.