Abstract: Neurogenic tumors account for approximately 10%–20% of retroperitoneal lesions and are mostly located in the paraspinal sympathetic chain (kidney-level paravertebral). Paraganglioma is a pheochromocytoma outside the adrenal gland. It originates from ganglionic crest cells and can be seen all over the body. Paraganglioma is most common at the front of the branches of the abdominal aorta and the inferior mesenteric artery. Given that paraganglioma does not have typical imaging features and clinical manifestations, it is often difficult to identify from other various retroperitoneal lesions. In this study, two paraganglioma cases, which were not easy to differentiate from other retroperitoneal lesions in ¹⁸F-FDGPET/CT imaging, were selected. A differential diagnosis was also made from their clinical and imaging features. The diagnostic ideas were summarized and analyzed as a reference for accurate imaging diagnosis in clinical work.