A case is presented in which suprarenal neurilemoma was associated with paroxysmal attacks of hypertension, headache and sweating with elevated plasma and urinary catecholamines. Pheochromocytoma was excluded using an overnight clonidine suppression test. Ultrasonography, computed tomography and magnetic resonance imaging, which showed cystic mass with a pedicle continuing to the widened intervertebral foramen, were helpful for the preoperative diagnosis of retroperitoneal neurilemoma. The excised tumor was revealed to be benign neurilemoma and contain detectable levels of adrenaline, noradrenaline and dopamine. The relationships between tumor catecholamines and clinical manifestations will be discussed.