Paraganglioma is a neuroendocrine neoplasm that may develop at various body sites, including the head, neck, thorax, and abdomen. Approximately 85% of paragangliomas develop on the abdomen, 12% develop on the chest, and only 3% develop on the head and neck. These tumors are found in locations that parallel the sympathetic chain ganglion in the thoracolumbar regions and parasympathetic nervous system in craniosacral regions, and all head and neck paragangliomas arise from the parasympathetic nervous system. Although the skin has a rich neural network, it is devoid of ganglia. There has been only 1 report of a paraganglioma on the scalp of a child. We describe a 3-year-old child with a primary cutaneous paraganglioma of the vertex scalp and review the literature on paragangliomas.