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Background/Aims In recent years, a significant increase in incidence of rectal neuroendocrine tumors (NETs) has consequently increased in the importance of their optimal treatment and post-treatment management. Endoscopic resection has become a primary option for the treatment of grade 1 rectal NETs, less than 10 mm, but there is also a higher risk of residual tumors, compared to surgical resection. The study aimed to investigate the clinical outcomes of incompletely resected grade 1 rectal NETs and risk factors associated with prediction of residual tumors after salvage treatment. Methods Patients with grade 1 rectal NETs who underwent incomplete endoscopic resection from 2008 to 2023 were enrolled and their medical records were reviewed retrospectively. Finally, a total of 205 rectal NETs with the pathologic reports of incomplete resection were collected for data analysis. Results Among 205 patients, 76 patients received the salvage treatment and 126patients had been on a regular follow-up schedule without the salvage treatment. The mean follow-up period of enrolled patients was 35.0±37.6 months. The mean follow-up period of the salvage treatment and regular follow-up groups was 33.5±28.3 and 35.9±42.2 months, respectively. Local recurrence, metastasis, and disease-free survival rates did not show significant differences between the salvage treatment and regular follow-up groups. In the salvage treatment group, residual tumors were found in 23 (32.4%) patients. Primary endoscopic resection methods such as cold forceps, cold snare polypectomy, and conventional endoscopic mucosal resection (EMR), and primary endoscopic resection at non-tertiary medical center were the significant risk factors associated with residual tumors after the salvage treatment Conclusion Primary endoscopic resection methods such as cold forceps, cold snare polypectomy, and conventional EMR, and primary endoscopic resection at non-tertiary medical centers were the significant risk factors associated with prediction of the residual tumors after salvage treatment. [ABSTRACT FROM AUTHOR]