Paragangliomas are rare tumors arising from extra-adrenal chromaffin cells. We examined the clinical characteristics of all patients at our institution having paragangliomas resected from 1984 through 2005. Of 253 resections, 22 (9%) were retroperitoneal and were selected for further study. The ratio of males to females was 1.3:1, and the median age was 39 years. The average size, rate of metastasis (i.e., malignancy), and rate of function was 7.4 cm, 9.5%, and 57.1%, respectively. Tumors larger than 7 cm were more likely to require adjacent organ resection (P = 0.01). The overall 5-year survival was 73%. Survival was significantly worse after metastasis (P = 0.0023) but did not depend on the tumor diameter, the secreting function of the tumor, the status of surgical margins of resection, or status of the resected lymph nodes.