Pheochromocytoma is a rare cause of hypertension in pregnancy that can be life threatening to both the pregnant woman and the fetus. Diagnosing pheochromocytoma during pregnancy can be difficult, as there are other reasons for hypertension in pregnancy that are more common. As soon as the diagnosis is suspected, alpha blockade should be started immediately while completing the workup and continued until surgery. The recommendations for surgery come largely from experiences described in case reports due to the nature of the disease. Evidence suggests that adrenalectomy should be performed during pregnancy if diagnosis is made first 24 weeks gestation; if the patient is diagnosed after 24 weeks gestation, adrenalectomy should be delayed until after delivery. Diagnosing and managing pregnant patients with pheochromocytoma is a complicated endeavor and must be undertaken with a multidisciplinary team.