Pheochromocytoma is a rare catecholamine-producing tumor that can cause severe hypertension and other systemic disturbances. A clinical challenge arises when a patient with a previously undiagnosed and untreated pheochromocytoma presents with a surgical emergency. We describe a patient presenting with acute appendicitis in whom surgery was cancelled because of suspected pheochromocytoma. The possibility of mortality associated with surgery in a patient with an undiagnosed pheochromocytoma outweighed the risk of nonoperative management for appendicitis. This case resulted in a nonoperative resolution of appendicitis and an unremarkable recovery once appropriate hypertension treatment was administered.