Enucleation is the traditional surgical procedure for removal of sporadic insulinoma, but this may associated with recurrence. This is a case report of thirty-five years old woman, who underwent enucleation for solitary insulinoma at the head of pancreases three years ago. Recently, she was complaining from recurrent attacks of hunger pain, dizziness, sweating, convulsion, behavioral changes and loss of consciousness. Endoluminal ultrasound revealed that there are bilobed mass or probably two masses related to the head/neck region of the pancreas about 1.5 cm in diameter. So the diagnosis of recurrent insulinoma was made and she was treated by complete resection with 1cm safety margin by harmonic scalpel guided by intraoperative ultrasound. The recurrent insulinoma reported in this article and others may give attention to change the strategy of treating solitary insulinoma by local resection with good safety margin rather than by enucleation to prevent recurrence.