Large, highly vascular pelvic tumors can be challenging to manage, and bleeding is a major concern of the surgeon. Other concerns relate to the risk of injury to associated pelvic structures, difficulties in operative exposure, and complete tumor removal. We report an unusual case of a massive retrorectal lipomatous hemangiopericytoma managed successfully by preoperative vascular embolization and a multidisciplinary surgical team. The combined efforts of an interventional radiologist, vascular surgeon, orthophedic oncologist, and colorectal surgeon led to successful and safe complete removal of the tumor.