Aim: To manage a rare case of paraspinal paraganglioma in an 8-year-old female. Background: Functional paraspinal paragangliomas are exceptionally rare entities in both adult and pediatric age groups. These tumors are closely associated with major vascular structures like the aorta and are in close proximity to the spinal nerves and threatened with deadly vascular complications (e.g., hemorrhagic shock) and neurological complications (e.g., paralysis or paresis of the lower limb). So managing pediatric patients with safe outcomes is a challenge. Case description: An 8-year-old female child presented with a two years history of headache, palpitations, sweating, and high blood pressure with no neurological deficit. On evaluation, she was found to have elevated urinary normetanephrine levels and a left lateral paraspinal mass located at the level of T7–T11 vertebral bodies on imaging. She was managed with preoperative alpha-adrenergic blockade followed by complete tumor resection. Conclusion: Biochemical evaluation, perioperative care with adequate α-blockade, and timely follow-up is necessary for best outcomes in functional paraspinal paraganglioma. Clinical significance: High suspicion of an index and multidisciplinary teamwork were key in diagnosing and managing this rare tumor.