Objective To summarize the clinical characteristics of paraphysial metastasis of pheochromocytoma with skull invasion and review the related literature. Methods A retrospective analysis was conducted on the case data of a patient with paraphysial metastasis of pheochromocytoma with skull invasion, admitted to the Department of Neurosurgery at the First Affiliated Hospital of Nanjing Medical University in February 2023. In addition, 17 cases of brain metastasis from pheochromocytoma were retrieved from PubMed, and the challenges in diagnosis and treatment options were discussed. Results The tumor was completely resected through a transnasal approach exposing the sellar floor and clival recess. Postoperative pathological diagnosis confirmed pheochromocytoma. Conclusions Parasellar metastasis of pheochromocytoma with skull invasion is rare, which poses significant diagnostic challenges. The primary treatment of choice is complete surgical resection.