This is a report of a 32-year-old man who presented with dyspnea upon micturition. He was found to have hematuria. Pelvic ultrasound and CT scan of the abdomen and pelvis revealed a left bladder wall polyp confirmed by cystoscopy to be a submucosal pulsating mass. Plasma free metanephrines were elevated in favor of a bladder paraganlioma while urinary metanephrines, catecholamines and MIBG scan were normal. Patient was managed by partial cystectomy with disappearance of symptoms thereafter. Pathology showed a completely excised paraganglioma. The assessment, diagnosis and treatment are illustrated.