Paraganglioma is a rare type of neuroendocrine tumor with variable clinical presentations, making diagnosis relatively challenging. In this report, we present a case of retroperitoneal paraganglioma in a patient who experienced intermittent episodes of dizziness and chest pain. Imaging studies conducted during the patient's hospitalization revealed the presence of a lesion in the upper region of the right kidney, as well as a mass in the left retroperitoneal area that was suspected to be a paraganglioma. Biochemical studies were collected, including 24-hour urine metanephrines, urine catecholamines, urine cortisol, plasma metanephrines, renin, and aldosterone. However, it took an extended period of time for these results to come back. Given high clinical suspicion, alpha-blockade was initiated without a definite diagnosis of paraganglioma. Ultimately, the patient underwent tumor resection and the final pathology confirmed paraganglioma. The pathology of the contralateral renal mass showed oncocytoma. This case serves as an illustration of the difficulties that can arise when diagnosing and treating undiagnosed paragangliomas within a community healthcare setting.