Adult Neuroblastomas are rare tumors and pelvic type represents less than 5% of these tumors. Here, I will report the case of 38-year old Saudi female patient with adult pelvic neuroblastoma. Results: the patient presented to the outpatient clinic with lower abdominal discomfort and distension for 6 months duration. Examination revealed large pelviabdominal mass of limited mobility. Laboratory findings were within normal, however, CT scan and MRI, revealed retroperitoneal tumor shifting the pelvic organs anteriorly and to the right. The tumor was resected completely through anterior midline approach. Pathological diagnosis revealed that the tumor was a neuroblastoma. The patient received 6 courses of chemotherapy and follow up for more than 6 years revealed no recurrence or metastasis. Though the outcome of adult neuroblastoma is poor, complete surgical resection with postoperative chemotherapy may improve the survival; however, a long-term evaluation of adult neuroblastoma is mandatory.