Laparoscopic operation is considered to be the optimal for treatment of pheochromocytoma nowadays. Though by the large size of the tumor the laparoscopic approach can be quite troeblecome because not only difficulties with the central tumor vein identification and visualization, but severe intraoperative hemodynamic disorders. On the other hand, the traditional open surgery for such patients has certain technical features and requires a more thorough and intentional examination. Data of 5 operated patients with giant pheochromocytoma was processed and analyzed. Features of the preoperative examination and operative technique were described.