Background/Objectives <p>Advanced neuroendocrine tumors usually have poor prognosis. Recent research shows that four cycles of [¹⁷⁷Lu]Lu-DOTATATE therapy improve outcomes. This study aimed to evaluate the safety and efficacy of [¹⁷⁷Lu]Lu-DOTATATE in a consecutive cohort of patients with advanced, well-differentiated NETs treated at a single tertiary center in Jordan.</p> Methods <p>Data from consecutive patients with advanced well-differentiated NETs treated with [¹⁷⁷Lu]Lu-DOTATATE at our center from January 2014 until the end of December 2024 were retrospectively reviewed. Safety, efficacy, progression-free survival (PFS), and overall survival (OS) outcomes were analyzed. Statistical analysis was performed using Stata software, version 16, with a p-value of &lt; 0.05 established as the threshold for statistical significance.</p> Results <p>A total of 31 patients were included in the analysis, with a mean age at diagnosis of 51 ± 9.1 years. The cohort showed a slight male predominance (64.5%). Across all patients, 111 cycles of [¹⁷⁷Lu]Lu-DOTATATE were administered, yielding an overall response rate of 29% and a disease control rate of 80.6%. Median overall survival (OS) was 32 months, and median progression-free survival (PFS) was 17.9 months. Reported adverse events were mostly self-limiting and reversible, with nausea and leukopenia being the most frequent (22.5% for each), followed by thrombocytopenia (19.8%), the latter demonstrating the highest rate of high-grade toxicity (5.4%).</p> Conclusions <p>In this real-world cohort, PRRT with [¹⁷⁷Lu]Lu-DOTATATE demonstrated favorable disease control and an acceptable safety profile in patients with advanced SSTR-positive NETs. These findings are consistent with previously reported outcomes and support the feasibility of delivering PRRT in this setting.</p>