Hypertension is often the primary presenting symptom of multiple renal pathologies. Overactivity of the Renin-Angiotensin-Aldosterone-System (RAAS) is a common cause and usually results from an induced physiologic response. However, conditions do exist that involve autonomous renin production. Juxtaglomerular cell tumors (JGCT), or reninomas, are renal lesions that cause refractory hypertension via this mechanism. Symptoms and lab abnormalities usually subside with surgical resection of these tumors. Here, we present a case of a 13-year old female with uncontrolled hypertension secondary to reninoma treated with partial nephrectomy, with focus on initial presentation, diagnostic evaluation, and surgical management of this uncommon tumor.