Pheochromocytoma can cause dramatic fluctuations in blood pressure, which can be as high as 200 mmHg or more, and even the possibility of cerebrovascular accidental death, so it is important to seek immediate medical attention, otherwise it may be life-threatening! Adrenal pheochromocytoma accounts for 90% of cases, 10% occur in other sites (such as the bladder); 10% may be malignant. In addition, another 10% of adrenal pheochromocytomas are bilateral and are extremely difficult to manage. What is the management of bilateral adrenal pheochromocytomas? Which is better: minimally invasive laparoscopic technique or open surgery? We report a typical case, i.e., the patient was treated with open surgery for one side of the tumor and then with laparoscopic technique for the other side of the giant adrenal pheochromocytoma, comparing the effects of the two modalities on the patient for your reference before surgery. History: The patient, YU Moumou, female, 36 years old (born on November 28, 1975), was found to have bilateral adrenal pheochromocytomas on CT in Jiangxi on March 12, 2012 due to recurrent malignant hypertension for 2 years, and underwent open right adrenal pheochromocytoma resection. Although the open surgery was successful, the large surgical incision and slow postoperative recovery were devastating to the patient. Meanwhile, the patient’s thin body and long-term hypertension led to poor physical condition, therefore, the patient came to our hospital for minimally invasive laparoscopic surgery to deal with the left adrenal pheochromocytoma. Treatment process: In July 2012, after a series of preparations such as adequate dilation in our hospital, laparoscopic left-sided giant adrenal pheochromocytoma was performed by myself, and the operation went very smoothly without any complications, and the patient got out of bed quickly. The blood pressure returned to normal level after more than 1 year of follow-up after surgery. (With pictures) Discussion: Bilateral adrenal chromophores lead to malignant hypertension, and improper management may lead to life-threatening conditions. Long-term hypertension in such patients affects the patient’s life, appetite, and sleep, and the patient is in an extremely depleted and wasted state. How to give bilateral adrenal chromophobe patients a surgical treatment that is both safe and reduces the patient’s pain and fast recovery is a challenge for doctors! Bilateral adrenal chromophoresis has great difficulty and high risk, but as long as adequate preparation is performed before surgery, and at the same time, the surgeon has rich clinical experience and high minimally invasive surgical techniques, laparoscopic surgery may be the best choice, which can fully meet the requirements of the above patients: to achieve aesthetic, safe, minimally invasive and fast recovery! We hope this case can give a reference to our patients and friends before surgery.