Most of us think that hypertension is the patent of elderly patients, and that it is less common in young and middle-aged people. In fact, with changes in diet, lifestyle habits, and psychosocial factors, hypertension is increasing among young patients, and is also attracting the attention of clinicians, which we call “youthful” hypertensive patients. A large proportion of these patients are caused by the corresponding etiology, i.e. hypertension is only a manifestation. We would like to introduce you to a common urological cause of hypertension, or even an invisible killer, namely pheochromocytoma. Most pheochromocytomas originate from the adrenal glands, and a small number of them can be ectopic to the retroperitoneum or even to other organs. Pheochromocytomas are mostly benign and rarely malignant, but their clinical behavior has a “malignant” tendency, i.e., they cause a series of conditions that can be life-threatening, with a very high rate of cardiovascular and cerebrovascular ectopia. Here we will briefly discuss the pathogenesis of pheochromocytoma: Pheochromocytoma secretes and releases catecholamine hormones for a long period of time, which cause an increase in blood pressure, atherosclerosis of small arteries, aortic atherosclerosis, and cardiac weight gain, enlargement, and cardiomyocyte hypertrophy. When triggered, a large amount of catecholamine hormones are rapidly released into the blood, resulting in fibrinoid necrosis of small arteries, rupture and bleeding of aortic atheromatous plaques, acute myocardial ischemia, cardiac rhythm disturbance and cardiac failure, which cause corresponding clinical symptoms. Clinical manifestations include dizziness and headache, profuse sweating, nausea, vomiting, palpitations, fatigue, irritability, hemoptysis, and fever. The triad of headache, palpitation and sweating is the typical clinical manifestation of pheochromocytoma. Some patients die of cardiovascular disease and have a significant increase in blood pressure. We also need to understand that a large proportion of pheochromocytoma patients have no clinical manifestations, which we call functionally quiescent pheochromocytoma, but can appear under trauma, stress, infection and other triggers, and may be life-threatening at any time, so he is an invisible killer. The diagnosis and treatment of pheochromocytoma is not difficult, but it is crucial that we fully understand its danger to our human health, especially for our young patients, which can be fatal and disabling, so we are required to detect and treat it early.