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Abstract Background The survival of dogs with pheochromocytoma (PCC) treated with adrenoreceptor antagonists has not been described or compared to surgically managed cases. Hypothesis/Objectives The objective of this study is to evaluate the survival of medically and surgically managed dogs with PCC and investigate factors associated with survival. Animals Two hundred fifty-five dogs with PCC, treated with alpha-adrenoreceptor antagonists (AA) without adrenalectomy (Group 1, n = 75), adrenalectomy +/– AA (Group 2, n = 128), or neither treatment (Group 3, n = 52). Methods Retrospective, multicenter review of medical records. Median overall survival time (OST) for Groups 1 and 2 combined was calculated using Kaplan–Meier estimates, and then compared between Group 1 and Group 2 using Log-Rank testing. Cox proportional hazard analysis identified factors associated with survival in Groups 1 and 2 individually and combined. Results Median OST for all cases was 854 (95% CI: 572–1136) days. Median OST was lower in Group 1 (247 days, 95% CI: 76–418 days) than in Group 2 (927 days, 95% CI: 587–1267 days; p < 0.001). In Group 2, 88/92 dogs (97.8%) that received presurgical AA treatment survived to discharge compared to 23/27 (85.2%) that did not receive AA pretreatment (p = 0.03). Lack of clinical signs at presentation was associated with increased survival in both groups combined (HR 0.5; 95% CI 0.3–0.9; p = 0.02) and in Group 2 alone (HR 0.3; 95% CI 0.1–0.7; p = 0.01). Conclusions and Clinical Importance Dogs with PCC treated with adrenalectomy have longer survival compared to those managed with AA without adrenalectomy.