Background: The detection rectal neuroendocrine tumors (RNETs) is increasing due to prevalence of routine colorectal cancer screenings. Although many of these tumors are considered less aggressive, their behavior can be unpredictable, presenting significant therapeutic challenges. Smaller, well-differentiated tumors that don’t invade deeply can often be removed safely through local excision without affecting long-term outcomes. Case Report: In this case report, a 59-year-old patient presented with rectal bleeding after bowel movements. A colonoscopy revealed a 10 mm nodule located 7 cm from the anal verge. Subsequent biopsy confirmed it was an RNET. The tumor was completely removed through transanal excision, and further testing showed favorable markers such as low Ki-67 and negative margins. Conclusion: This case highlights that transanal excision can be an effective, organ-preserving option for carefully selected patients. However, precise staging, detailed pathology, and consistent follow-up are essential, since even small tumors may rarely spread.