Insulinoma is rare pancreatic neuroendocrine tumor that is usually described as benign and sporadic. It is seen mostly in women at the ages between 40 and 60 years. Insulinoma can cause hypoglycemic attacks which may lead to serious consequences. Here we report a case of an 82 years old woman with the diagnosis of insulinoma presented by cerebrovascular disease due to severe hypoglycemia. Early diagnosis of the disease is essential to prevent lethal hypoglycemia. The first choice of treatment is surgery. However in the elderly, medical treatments may be preferred as primary treatment due to the existing comorbidities. For this case, it was possible to control the hypoglycemic attacks by using diazoxide and octreotide treatment. So that continous dextrose infusion is not necessary.