This case report presents a 22-year-old male with no previous history of headaches who presented with a prolonged migraine-like attack unresponsive to standard therapy. Associated features included severe hypertension, tremor, and profuse sweating. Further investigation revealed an underlying pheochromocytoma. Surgical resection led to full resolution of symptoms including headache. Pheochromocytoma may present with atypical refractory headache along with hypertension, sweating, and palpitation. Prompt diagnosis is crucial for effective management. Thus, atypical features of migraine-like attacks that do not respond to standard acute treatment require deep investigation, including tests for pheochromocytoma.