Tumors of the adrenal glands are mostly benign and they are most commonly detected during radiological treatment due to other symptoms and are called incidentalomas. Most adrenal tumors are hormone inactive. Active tumors of the adrenal glands produce certain hormones and lead to the development of a characteristic clinical picture. Operative treatment is usually the first choice in the treatment of clinically significant adrenal gland tumors. Over the past twenty years, minimal invasive laparoscopic adrenalectomy has been imposed as a gold standard for the treatment of most benign lesions of the adrenal gland. Compared with open adrenalectomy, beacuse of its minimaly invasive aproach, it is associated with fewer complications, less postoperative pain, faster recovery, and shorter hospitalization. Current indications for laparoscopic adrenalectomy include functional tumors of the adrenal gland, nonfunctional tumors larger than 4 centimeters and those whose radiological properties indicate malignancy or their size significantly increases in a short time interval. Indications also include symptomatic adrenal cysts, myelolipomas, and bilateral adrenal hyperplasia. Laparoscopic approaches have an advantage over the open, except in cases of adrenocortical carcinoma and tumors larger than 8 centimeters. Nonetheless, with ongoing development techniques, such tumors can be managed laparoscopically, but with greater risk of complications and conversions in open access. There are two surgical approaches to laparoscopic adrenalectomy; transperitoneal and retroperitoneal. With transperitoneal access, it is possible to create a larger field of operation with better visibility, and the retroperitoneal access reduces the risk of internal organ injuries and postoperative ileus. Both surgical techniques are highly effective in the hands of experienced surgeons and there are no significant differences in the ultimate outcomes of the operation.