Pheochromocytoma is a rare neuroendocrine tumor consisting of chromaffin cells of the adrenal medullary layer, a special case of sympathetic paraganglioma. The classic clinical sign of pheochromocytoma is a sympathoadrenal crisis characterized by attacks of a significant increase in blood pressure, tachycardia, severe sweating, and vasomotor reactions. This article describes a rare case of pheochromocytoma with a non-classical onset of the disease with a combination of nonspecific symptoms and no hypertension at the onset of the disease. The patient, 57 years old, presented in the National Medical Research Center for Endocrinology with general weakness, fatigue, anxiety attacks up to 2—3 times a day, and increased sweating. Previously, these symptoms were attributed to the persistence of menopausal syndrome; also, a mass in the adrenal gland of 40×37×39 mm was identified with a heterogeneous structure, a density in the native phase from 26 to 39 HU, and an absolute washout rate of 51%. With additional examination, the results of laboratory tests (metanephrine in daily urine 629 μg/day, normetanephrine 1331 μg/day) combined with modern imaging methods contributed to the diagnosis of pheochromocytoma followed by the effective surgical treatment. Morphological and immunohistochemical data corresponded to pheochromocytoma of the left adrenal gland, PASS 2 score. After surgical treatment, the patient achieved normotension without additional drug therapy. Vasomotor symptoms typical of pheochromocytoma may be overlooked by clinicians, especially in cases without hypertension or with comorbidities with similar clinical manifestations, as in the presented clinical case. It supports excluding the hyperproduction of catecholamines in cases of adrenal masses with indeterminate and malignant computed tomography phenotypes, regardless of the presence of symptoms.