This study aims to compare insulinoma localization with CECT, VPCT and multi-parametric MR (mp-MR) at 3T in the same patients, in a prospective manner. CECT, VPCT and mp-MR were performed in patients with suspected insulinomas. The presence/absence of tumor within the pancreatic head, neck, body and tail region was evaluated with 5-scale confidence levels. ROC analysis was performed. Surgical pathology served as reference standard. We found that VPCT and mp-MR showed improved diagnostic performance for insulinoma localization, compared to CECT. Both modalities could serve as problem-solving tools in difficult cases. mp-MR has the potential to replace CECT as the first-line examination.