Objectives: Ganglioneuroma is a rare, benign neurogenic tumor arising from the sympathetic ganglia. In this report, we reviewed and summarized the clinical features,treatment, and prognosis of a posterior mediastinal ganglioneuroma. Case: Here, we report on a 29-year-old man referred to us with transient pain in the right side of the chest, lasting for three days. Physical examination revealed no abnormalities.The results of routine laboratory tests were within the normal ranges. Thoracic spinal magnetic resonance imaging showed a well-defined, solid mass in the right paravertebral region at the T5-T8 level, measuring 7.5 cm × 4.2 cm × 1.5 cm. To accurately locate the lesion during surgery, O-arm intraoperative imaging was used in conjunction with the Stealth Station navigation system. The tumor was completely excised and no related complications occurred. The tumor was an encapsulated mass with a solid, homogenous, grayish-tan cut surface. Histopathological examinations confirmed that the mass was a ganglioneuroma. Conclusions: Ganglioneuroma is a rare, benign tumor. Prior to treatment, a careful imaging evaluation is necessary in order to obtain an accurate diagnosis. A definitive diagnosis can be made by histological examination. En bloc resection is the preferred treatment for ganglioneuroma as it has an excellent prognosis. Objectives: Ganglioneuroma is a rare, benign neurogenic tumor arising from the sympathetic ganglia. In this report, we reviewed and summarized the clinical features, treatment, and prognosis of a posterior mediastinal ganglioneuroma. Case: Here, we report on a 29-year- old man referred to us with transient pain in the right side of the chest, lasting for three days. Physical examination revealed no abnormalities. The results of routine laboratory tests were within the normal ranges. Thoracic spinal magnetic resonance imaging showed a well-defined, solid mass in the right paravertebral region at the T5-T8 level, measuring 7.5 cm × 4.2 cm × 1.5 cm. The accurately positioned the lesion during surgery, O-arm intraoperative imaging was used in conjunction with the Stealth Station navigation system. The tumor was completely excised and no related events occurred. The tumor was an encapsulated mass with a solid, homogenous, grayish-tan cut surface. Histopathological examinations confirmed th at the mass was a ganglioneuroma. Conclusions: Ganglioneuroma is a rare, benign tumor. Prior to treatment, a careful imaging evaluation is necessary in order to obtain an accurate diagnosis. A definitive diagnosis can be made by histological examination. En bloc resection is the preferred treatment for ganglioneuroma as it has an excellent prognosis.