A young patient underwent laparoscopic resection of a giant pheochromocytoma in the adrenal gland, which was about 15cm*13cm*12cm in size. The patient was 23 years old and was admitted to our hospital because of a large left adrenal gland occupancy and severe hydronephrosis in the left kidney. The patient was admitted to the hospital and was considered to have pheochromocytoma of the left adrenal gland and left hydronephrosis after completing relevant auxiliary examinations. He was given adequate hypotension and volume expansion for 2 weeks, and ultrasound-guided left nephrostomy with drainage was performed 1 week before surgery. After discussion and full communication with the patient, we decided to perform “laparoscopic adrenal giant pheochromocytoma resection + left nephrectomy”. Preoperatively, radial artery was placed to measure arterial pressure and central vein was placed to measure pressure. During the operation, four laparoscopic channels were established in the umbilicus and left abdomen, and the lateral peritoneum was incised from the left paracolic sulcus, the splenic colonic ligament was incised, and the splenic flexure of the colon and descending colon were drawn medially. The perirenal fascia was dissected and the left adrenal mass was freed from the perirenal fascia. The left adrenal mass was seen to be huge and its surface was covered with blood vessels. Careful separation was given along the surface of the mass to avoid injury to the intestinal duct, pancreas, spleen, renal vessels, abdominal aorta and other branches. The thickened central adrenal vein was freed and sought, and Hem-O-Lock gave a clamp to cut it, and other vessels around the adrenal mass were freed and cut. Blood pressure fluctuated significantly during the separation and was effectively controlled. An abdominal incision, approximately 12 cm in length, was made to remove the resected tumor. Using this incision, the left kidney and ureter were explored. There were two stenoses in the upper part of the left ureter, and the stenosed ureter was removed and pyeloplasty was performed. The postoperative pathology showed: pheochromocytoma of the left adrenal gland. The patient’s blood pressure remained low for 2 days after surgery, and normalized after further blood transfusion and volume expansion. At present, the patient has been discharged from the hospital. Adrenal pheochromocytoma originates from the chromaffin cells of the adrenal medulla. The tumor secretes catecholamines, which causes symptoms such as elevated blood pressure, headache and excessive sweating. The patient was vasoconstricted with lower than normal blood volume and required preoperative fluids for volume expansion. Also, increased catecholamines and hypertension lead to cardiomyopathy, and myocardial function should be improved before surgery. Currently, laparoscopic surgery is recommended for the removal of pheochromocytomas under 6 cm, and open surgery is recommended for larger pheochromocytomas. With the continuous improvement of laparoscopic technology, larger pheochromocytomas can also be removed by laparoscopic surgery. The success of laparoscopic surgery for this case of giant pheochromocytoma was attributed to adequate preoperative preparation, correct level of separation, skillful laparoscopic operation and close cooperation between the surgeon and anesthesiologist.