A 16 year old male with a four year history of recurrent pheochromocytoma develops multiple osseous lytic lesions in the skull, clavicle, ribs, and fibula all of an expansile, ill-defined appearance. These are biopsy proven metastatic sites. To our knowledge this is the first reported proven case of malignant extra-adrenal or adrenal pheochromocytoma with multiple bone metastases in a child.