Ganglioneuroma is an extremely rare tumor that is derived from neural crest. Many ganglioneuroma cases are detected incidentally unless they are large enough to cause compressive symptoms. We report an 18-year-old patient with posterior mediastinal ganglioneuroma which was abutting the descending aorta. The patient underwent successful resection by thoracoscopic approach and was followed up for one year with no complications. In summary, a detailed review with experts in both radiology and pathology is mandated to diagnose these tumors. Informed consent was obtained from the patient.