Background: Small-bowel neuroendocrine tumours (SBNETs) frequently involve mesenteric lymph nodes. While guidelines suggest minimum lymph node yields (LNY), the independent prognostic relevance of LNY and lymph node ratio (LNR) regarding recurrence remains uncertain in contemporary cohorts. Methods: A retrospective analysis of 102 patients undergoing R0/R1 resection for SBNETs (2005–2023) at a single tertiary institution was conducted. Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). Literature-informed thresholds (LNY >8, LNR ≤0.46) were applied and validated using exploratory cut-point analysis. Predictors of outcome were assessed using Kaplan–Meier survival analysis and multivariable Cox and logistic regression models. Results: The median LNY was 11, with 85% of patients achieving >8 nodes. At a median follow-up of 8.1 years, 5-year OS and RFS were 86.0% and 73.8%, respectively. In unadjusted analysis, LNY >8 and LNR ≤0.46 were associated with improved OS (p=0.038 and p=0.046), but did not reach statistical significance for RFS (p=0.111 and p=0.083). Furthermore, neither nodal metric remained a significant predictor of survival or recurrence after multivariable adjustment. Independent predictors of recurrence were higher Charlson Comorbidity Index (OR 1.90 per point; p<0.001), younger age (OR 0.93 per year; p<0.001), and higher Ki-67 index (OR 1.36 per %; p=0.011). Conclusions: In this cohort, adequate lymphadenectomy (>8 nodes) assisted staging. While unadjusted analysis suggested a survival benefit, nodal metrics were not statistically significant predictors of recurrence or survival after multivariable adjustment, likely reflecting the dominant influence of tumor biology (Ki-67) and host comorbidity. Prognostication and surveillance strategies should prioritize biological markers and patient factors over surgical nodal metrics alone.