Children with pediatric neuroblastoma often have late diagnosis, tumor spread, and poor outcome. It is necessary to ask parents of children to pay attention to the following symptoms for timely consultation: (1) Retroperitoneal neuroblastoma Children often come to the clinic with unexplained fever and pale face. Tumors originating from the adrenal gland are not easy to find due to their high location, which is covered by the cartilage of the rib cage. If the mass originates from the sympathetic chain and is large, a hard, nodular, inactive, non-pressure mass may be found in the abdomen, often beyond the midline. In advanced children, ascites, abdominal wall venous rage, and abdominal wall edema may be present. (2) Mediastinal neuroblastoma Mediastinal neuroblastoma is mostly located in the posterior mediastinal spine, with more upper mediastinum than lower mediastinum. They may be asymptomatic in the early stage and detected during chest radiography or fluoroscopy. Huge tumor compression may manifest as choking, respiratory tract infection, swallowing difficulties, and even circulatory disturbances. Compression of nerve roots in the spinal canal may cause abnormal sensation and pain in the upper limbs. During physical examination, it is often seen that the supraclavicular fossa on the affected side is full, and sometimes the upper pole of the tumor or the metastatic lymph nodes can be found. (3) Cervical neuroblastoma Tumor in the neck is easily detected, but it is also easily misdiagnosed as lymphadenitis or malignant lymphoma. It often causes cervical sympathetic nerve palsy syndrome (Hornu syndrome) due to compression of cervicothoracic (stellate) ganglion, which manifests as unilateral pupillary constriction, ptosis and iris heterochromia. If the tumor compresses the last few pairs of cerebral nerves, tongue extension to the opposite side may occur, and even difficulty in swallowing. (4) Pelvic neuroblastoma Although pelvic neuroblastoma is rare, it is located in the anterior sacral recess behind the rectum, and once it occurs, symptoms will appear at an early stage due to compression of adjacent organs. Constipation, flattening and thinning of stool, and difficulty in defecation often occur due to rectal compression; bladder compression leads to dyspareunia or urinary retention; advanced tumor develops suprapubic and lower limb edema due to compression of lymphatic vessels and veins. Rectal finger examination can palpate a hard mass in the front, and the upper pole is often not palpable. (5) Dumbbell-shaped neuroblastoma Dumbbell-shaped neuroblastoma refers to a paravertebral neuroblastoma extending through the intervertebral space into the epidural spinal canal. Mediastinal neuroblastoma is more frequent than ventral neuroblastoma, but ventral spinal canal neuroblastoma presents with more symptoms and is more severe. Clinically, there may be spinal stiffness, abnormal sensation, pain, and hyperreflexia on the finger snap test. Limb hypotonia and even paralysis may occur, and defecation and urination may be impaired.