Objective Middle ear adenomatous neuroendocrine tumor (MEANTs) is a rare entity and accounts for approximately 2% of all middle ear tumors。The patients usually have nonspecific symptoms，universal standard surgical procedures for different stages of these tumors remain elusive。The doctor has difficulties in diagnosing and treating the disease。Methods Three cases of MEANTs were collected from Xiamen University Zhongshan Hospital between 2020 and 2022。Endoscope examination、audiometry test and temporal bone CT were performed before the surgery and follow-up。Post-operative immunohistochemistry confirmed the diagnosis。Results The patients included two men。One MEANTs occurred on the right side，another occurred on the left side。Endoscope examination of one patients revealed that the right external ear canal was filled with polypoid tissue, tympanic membrane was not possible to visualize。another case presented with complete bulging of the tympanic membrane。In temporal bone CT, the soft-tissue mass located the middle ear was found to extend to the antrum and the external auditory canal。MEANTs tend to surround the ossicles without erosion；MRI images showed equalT1and T2 signals with intensifying in tympanum。Two patients underwent canal wall down mastoidectomy and ossicular reconstruction。Two cases all showed adenoid or solid nest-like structures in the pathological morphology. Immunohistochemistry showed varying degrees of positive expression of CK-P and Neuroendocrine markers. Two patients showed no evidence of recurrence during followed up。Conclusions MEANTs are rare middle ear masses with benign morphological features and slow local growth。The treatment is complete tumoral excision。Patients need to be monitored lifelong for early detection of recurrence。