A 7-year-old neutered male Dutch rabbit was presented for a two-week history of intermittent generalized weakness, dull mentation, episodic seizures, and documented hypoglycemia. Physical examination identified a grade III/VI bilateral systolic heart murmur, and bloodwork confirmed marked hypoglycemia (46 mg/dL). The rabbit was stabilized with an intravenous dextrose bolus followed by a constant rate infusion (CRI) of 5% dextrose in lactated Ringer's solution (3–4 mL/kg/hr). Abdominal ultrasonography revealed a 0.56 × 0.51 cm homogeneous, hypoechoic nodule in the right cranial abdomen. Computed tomography demonstrated a mildly contrast-enhancing nodule (0.31 × 0.57 × 0.72 cm) dorsal to the stomach’s lesser curvature and ventral to the portal vein, supporting a tentative diagnosis of insulinoma. Prednisolone (1 mg/kg PO q12h) was initiated five days after presentation. However, steroid-associated adverse effects, persistent hyperglycemia (>300 mg/dL), fluid retention, and bilateral congestive heart failure made continued medical treatment untenable. Pancreatic nodulectomy was performed 4.5 months after presentation, allowing cessation of prednisolone. Postoperative recovery was uneventful. Transient hyperglycemia (249 mg/dL) and intermittent hypoglycemia (<100 mg/dL) were managed with a CRI of 2% dextrose in lactated Ringer's solution (1–2 mL/kg/hr) and assisted feeding until normoglycemia (109–161 mg/dL) was achieved. Histopathology with immunohistochemistry demonstrated strong insulin immunoreactivity in the neoplastic cells, confirming insulinoma. Seven months postoperatively, the rabbit remains clinically normal with stable glucose levels (109–156 mg/dL) and no evidence of recurrence. To the authors’ knowledge, this is the first report describing successful surgical management of insulinoma via pancreatic nodulectomy in a rabbit.