Ganglioneuromas are mostly seen in adolescents and young adults and they are neurogenic tumors originating from sympathetic ganglions with a benign histology. Although ganglioneuromas are benign, the treatment is surgical as they can cause pain or compression symptoms, can be locally aggressive and can lead to cord compression. We present a young adult female with a ganglioneuroma of the right posterior mediastinum who presented with lower back pain, together with the clinical features, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) findings, differential diagnosis tips and their contribution to surgical planning.