Abstract Background: Pheochromocytoma is a well-recognized neuroendocrine tumor. Classical symptoms are well described, but recent studies have suggested that many patients are diagnosed incidentally. No studies have evaluated incidental pheochromocytoma with respect to year of diagnosis. Methods: A retrospective study was performed from January 1992- November 2006 to evaluate the frequency of incidental pheochromocytoma. Patients were included if pathological specimens were available. Results: 21 patients were included. 15/21 (71.4%) cases were incidentally discovered. 11/15 (73.3%) were diagnosed after 2000, while 4/15 (26.7%) were diagnosed before 2000. 15/21 (71.4%) patients had hypertension, and all 6 patients without hypertension had pheochromocytoma diagnosed incidentally. Only 3/21 (14.3%) patients were diagnosed by biochemical testing. Discussion: This observational study suggests an increasing number of incidental pheochromocytomas. Several possibilities for this observation include increased usage of imaging studies, decreased use of biochemical testing, and an increase in referring patients to surgeons for resection without an appropriate endocrine work-up. Referring physicians and surgeons alike should take note of this.