Neuroblastoma is the common extracranial solid tumor in children.Very often they are described as “enigmatic tumor” for its broad spectrum of clinical presentation and biological features. Prognosis varying from clinically incidence benign to unresectable or metastic disease with very poor outcomes. They may present with proptosis, periorbital ecchymosis, abdominal distension, bone pain, pancytopenia, fever, anemia, hypertension, paralysis, watery diarrhea, subcutaneous skin nodule and also with paraneoplastic syndromes. Very rarely they may present as a case of Fever of Unknown origin