After a subarachnoid hemorrhage, a 35-year-old patient developed paroxystic hypertension accompanied by typical symptoms. These symptoms occurred exclusively after urination. A urinary bladder paraganglioma was discovered using iodine-123 metaiodobenzylguanidine (I-123 MIBG) scintigraphy and magnetic resonance imaging (MRI) after the detection of an abnormally elevated plasma metanephrine measurement. A partial cystectomy was performed which cured the symptoms. Paragangliomas, defined by their extra-adrenal localization, have slightly different characteristics than pheochromocytomas, leading to specific care and follow up.