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Residual NET was found histologically in 14/37 lesions. All residual disease was found during salvage endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) and 43 % had a normal-appearing scar. Every patient undergoing EUS had an unremarkable exam. Initial cold biopsy polypectomy ( P  = 0.006), visible lesions ( P  = 0.001) and EMR/ESD of the prior resection site ( P  = 0.01) correlated with residual NET. Conclusions  Localized rectal NETs may be incompletely removed with standard polypectomy. If an advanced resec