Adrenal neuroblastomas, although quite common in children, are extremely rare in adulthood. Here, we are reporting the case of a 47-year-old male who presented with right flank pain and had a palpable mass in the same region. Contrast-enhanced computed tomography showed an irregular, poorly marginated heterogeneous mass lesion arising from the right suprarenal position. Urinary catecholamines were within normal limits. There was no evidence of metastatic disease. The mass was resected en-block along with the right kidney. Histopathologic examination revealed the diagnosis of a neuroblastoma. Adjuvant chemotherapy was instituted, but the pain recurred after 9 months. Despite subsequent chemotherapy, the mass continued to grow over the next 6 months with further infiltration into the liver and surrounding muscles. The patient has currently been started on external palliative radiation. We have also reviewed the literature to present a discussion on presentation, diagnosis, and management of this rare tumor.