Adrenocortical carcinomas are malignant and rare tumors, with a high risk of recurrence. According to the clinical presentation, they can be functional or non-functional, depending on whether they secrete hormones and their precursors. Functional tumors can secrete cortisol, aldosterone, androgenic hormones or estradiol, and depending on this they show signs of Cushing's syndrome, Conn's syndrome, virilization or feminization. Tumors are often associated with autonomous secretion of cortisol, the so-called subclinical Cushing's syndrome. The diagnosis is established by anamnesis, clinical findings, hormonal tests, radiological processing (mostly CT scans), and they can also be found as a random finding - incidentalomas. Treatment usually involves adrenalectomy and adjuvant mitotane administration to reduce the risk of recurrence. The aim of this paper is to demonstrate the relationship between the functionality of adrenocortical carcinomas and the patient's demographic characteristics, tumor characteristics (tumor size, Ki67 index and Weiss score), the course of the disease (the expansion of the disease at the time of diagnosis and occurrence of relapse) and the outcome of the disease. Comparing the groups of people with functional and non-functional tumors, significantly higher values of the Ki67 index and Weiss score were demonstrated in patients with functional tumors, as well as a greater number of patients with extended disease at the time of diagnosis. The difference between the groups according to the recurrence of the disease and the frequency of death is not statistically significant. In the sample, the largest number of patients had tumors that secrete androgenic hormones, and an equal number of patients had tumors that secrete cortisol and tumors that secrete two types of hormones. It has been proven that the frequency of tumors secreting cortisol and androgenic hormones is significantly higher in females compared to males.