Background: Octreotide has become a common choice for the treatment or prevention of carcinoid syndrome in route practice. However, its role in perioperative prevention and treatment of carcinoid crisis is controversial. Case Summary: We reported detailed perioperative management for a carcinoid crisis in a 28-year-old male patient diagnosed with duodenal carcinoid including anesthetic considerations and suggestions for applying octreotide. Approximately 30min after the induction of anesthesia, and immediately after manipulation of the duodenum, a carcinoid crisis was triggered. Soon after symptomatic treatment of this crisis, the vital signs and flushing gradually returned to normal. The surgical procedure lasted nearly 6 hours. As the patient did not have any clinical manifestations related to carcinoid syndrome, no octreotide was administered during this period. After the surgery, he was transferred to the intensive care unit. His postoperative course was uneventful with discharge 21 days after the initial procedure. Conclusion: Duodenal carcinoid crisis is rarely treated without octreotide. The patient had a good outcome after carefully preoperative preparation and timely symptomatic treatment. We hope to provide case support for standard perioperative management of carcinoid crisis in the future by summarizing the successful experience of this case.