A 3-month-old female with bilateral adrenal neuroblastoma had a unilateral adrenalectomy followed by cyclophosphamide treatment for 2 years. At 7, she has no evidence of disease. The favorable course of this patient and that of another young child reported with bilateral neuroblastoma as well as wide-spread metastases suggests that bilateral adrenalectomy may not be necessary for a child under 1 year of age with bilateral disease.