Paragangliomas in the vagina are extremely rare. Unwitting surgical excision of a functional paraganglioma may precipitate life-threatening complications. We present a case of a 38-year-old woman with a vaginal mass 3.0 cm in diameter who experienced a hypertensive crisis during an unwitting attempted surgical excision of the vaginal mass. The diagnosis of a vaginal functional paraganglioma was then made based on to her 16-year history of paroxysmal headaches, chest distress, palpitation and elevated levels of urinary vannillylmandelic acid (VMA). Consequently, after thorough presurgical preparation, the patient again underwent excision of the vaginal mass uneventfully. She has been followed-up for three years since surgery without any evidence of recurrence. The clinical features and perioperative management of functional vaginal paraganglioma are described.