A 29-year-old man with metastatic extraadrenal pheochromocytoma developed paraplegia which reversed completely after megavoltage irradiation of the dorsolumbar spine. Later, treated with cyclophosphamide, vincristine, and dacarbazine, he had a temporary decrease in plasma norepinephrine concentration, a partial recalcification of bone lesions, and a decrease in the need for antihypertensive treatment for 12 months. Irradiation and combination chemotherapy should be evaluated further in the management of malignant pheochromocytoma.