A single-center retrospective study enrolled 53 patients with recurrent hypoglycemia to compare the diagnostic performance of low-dose pancreatic CT perfusion (pCTP) imaging with conventional contrast-enhanced CT (CECT) and MRI in detecting insulinomas. pCTP demonstrated superior diagnostic performance for tumor detection and localization compared with both CECT and MRI, particularly among junior radiologists. Higher AUC values were reported for the pCTP parameters blood flow, peak enhancement, and mean transit time. pCTP may therefore serve as a complement to conventional imaging modalities for the detection of insulinomas.