INTRODUCTION: The incidental detection of rectal neuroendocrine tumors (NET) has increased but there is no proper consensus about treatment. OBJECTIVE: Evaluate the efficacy and safety of endoscopic treatment for rectal NET less than 20 mm, with emphasis in "standardized treatment". MATERIAL AND METHODS: From January 2012 to April 2016, we included patients with rectal NET less than 20 mm resected by conventional EMR, EMR-B and ESD. We considered as "standardized treatment" the one that has precise indication and technical rigor (EMR-B for lesions ≤ 10 mm and ESD for lesions between 11 and 20 mm). We evaluate complete resection rates and incidence of complications. RESULTS: 23 patients with 23 rectal NET were included. The mean age was 52.96 ± 12.44 years. The mean tumor diameter was 8.8 ± 3.4 mm. The complete resection rates by conventional EMR, EMR-Band ESD were 50 (3/6), 92.8 (13/14) and 100% (3/3), respectively; while by standardized and conventional treatment were 100 (14/14) and 55.5% (5/9), respectively. Complications occurred in 4 cases (17.4%), bleeding in 2 and perforation in 2, all of them solved by endoscopy. CONCLUSIONS: Endoscopic treatment by EMR-B and ESD is efficacious and safe for rectal NET ≤ 20 mm. Standardized treatment improve the efficacy of endoscopic treatment.