Pheochromocytoma of the urinary bladder is a rare tumor that occurs in <
1% of the extra-adrenal pheochromocytomas. Patients usually present with occult complaints, which can be misdiagnosed. We present a case of a patient with longstanding nonspecific debilitating symptoms. Functional imaging is crucial in diagnosing, localizing, staging, and guiding surgical planning of neuroendocrine tumors.