Objective To retrospectively analyze the feasibility and safety of surgical resection for patients with retroperitoneal ganglioneuroma involving abdominal major vessels.Methods A total of 23 patients with retroperitoneal ganglioneuroma involving abdominal major vessels (such as abdominal aorta, coeliac trunk and superior mesenteric artery) admitted to Changhai Hospital, Naval Medical University (Second Military Medical University) from Jan. 2020 to Sep. 2021 were enrolled. All patients underwent surgical resection and were confirmed by postoperative pathology. The clinical data including gender, age, tumor diameter, operation time, intraoperative blood loss, drainage duration, complications and follow-up outcomes were collected.Results Among the 23 patients, there were 9 males and 14 females, aged 36 (17-65) years. The surgery was successful in all cases, the operation time was 60 (45-170) min, the intraoperative blood loss was 100 (100-2 300) mL, the tumor diameter was 3 (3-11) cm, the postoperative hospital stay was 4 (3-14) d, and the drainage duration was 4 (3-20) d. Lymphaitc leakage occurred in 5 cases, and no serious postoperative complications (such as vascular rupture or occlusion) occurred. As of Nov. 2021, there was no tumor recurrence in the patients.Conclusion Though surgical resection for patients with retroperitoneal ganglioneuroma involving abdominal major vessels is difficult, it still could be a safe and reliable treatment when the surgeons have extensive vascular surgery experience.