Adrenal incidentaloma are described as adrenal lesions that are diagnosed incidentally during ab- dominal laparotomy or any other abdominal screening without prior suspicion of adrenal disease. It is important to diagnose adrenal lesions to know whether they are hormonally active or malignant .A small group of 5–7% of the functional ones can exist as pheochromocytoma. Pheochromocytomas (PCC) are rare type of neuroendocrine tumors of the adrenal medulla that arise from chromaffin cells. These cells are derived from neural crest and are innervated by the splanch- nic nerve of the sympathetic nervous system which releases acetylcholine that in turn binds to nico- tinic acetylcholine receptors of the adrenal medulla causing the release of catecholamines. The dopamine, norepinephrine, and epinephrine released from these tumors are causing the episodic hy- peradrenergic symptoms seen in these cases such as hypertension, palpitations, and headaches. This case report discusses about the incidental finding of a unilateral PCC in a 21-year-old woman who initially presented to our emergency department complaining of epigastric pain and hyperten- sion .