Abstract
Lower back pain with radiculopathy is a common clinical presentation caused by several conditions, some of which are rare pathologies that could have been overlooked during an initial assessment. This case report presents a patient complaining of chronic lower back pain and radiculopathy who finally received a diagnosis for his presacral ganglioneuroma. This 32-year-old male case illustrates the need to investigate atypical back pain presentations through proper image studies and multidisciplinary collaboration. Broad differential diagnosis helps identify and manage rare underlying causes to avoid poor patient outcomes.