Pheochromocytoma is a rare neuroendocrine tumor that arises from chromaffin cells of the adrenal medulla and secretes excess catecholamines. Clinically, it presents with various symptoms, with a hallmark of treatment-resistant hypertension, often accompanied by paroxysmal episodes of headache, sweating, and palpitations. Although its overall incidence is low, pheochromocytoma should be considered in the differential diagnosis of young patients with refractory hypertension despite the use of multiple antihypertensive agents, particularly when secondary hypertension is suspected. We present the case of a patient who developed a hypertensive crisis and hemodynamic angina, ultimately diagnosed with malignant pheochromocytoma with hepatic and pulmonary metastases.