Clinically non-functioning pituitary neuroendocrine tumours (NF-PitNETs) are relatively common, with an estimated clinical prevalence of approximately 1 in 1,000 and accounting for 15–30% of all PitNETs. They may be detected incidentally or present with symptoms related to mass effect. While the majority are of SF1 lineage (58–75%), NF-PitNETs display considerable clinical and pathological heterogeneity, creating challenges for decision-making regarding surveillance and intervention. Ongoing advances in the understanding of NF-PitNET biology are expected to support increasingly individualised management strategies for this diverse group of tumours.