<p>Bladder Paraganglioma (BPG) is a rare form of pheochromocytoma and paraganglioma (PPGL) characterized by elevated blood pressure when urinating, headache, dizziness, palpitations, and hematuria. Surgical resection is the most commonly used treatment for BPG. Here, we reporte a man who initially presented with hypogastralgia and hematuria and was diagnosed as BPG at local hospital. The size of mass was too huge to receive partial cystectomy at diagnosis. Then this patient was referred to our medical center. After evaluation, we chose temozolomide as neoadjuvant therapy to reduce the tumor size. Followed by seven cycles of temozolomide, the tumor was decreased and was successfully removed via partial cystectomy.</p>