Two patients with pheochromocytoma initially presented with behavioral symptoms similar to those seen with attention deficit hyperactivity disorder (ADHD): inability to concentrate, hyperactivity, and poor school performance. One patient was treated with dextroamphetamine/amphetamine for 4 months, at which time medication was discontinued when hypertension appeared. The second patient had hypertension when initially seen. All behavioral abnormalities resolved following tumor resection. Children with ADHD-like symptoms who present atypically at an older age or have other somatic signs and symptoms such as headaches and hypertension should undergo evaluation to rule out an organic etiology.