Paragangliomas are neoplasms that arise from neural crest cells and histologically resemble their adrenal counterpart, the phaeochromocytoma. The majority of extra-adrenal tumours develop within the abdomen and are associated with the coeliac, superior and inferior mesenteric ganglia, which run parallel to the aorta. The organ of Zuckerkandl origin is most common. Pararectal paragangliomas are extremely rare. This case report presents ultrasound, magnetic resonance and histological features of such a case.