The development of two hormonally active tumours in one adrenal gland is a very rare event. Four cases with this condition are reported. Clinical, instrumental, and morphological characteristics of aldosteromas and pheochromocytomas are presented. Peculiarities of anesthesiological management of such patients are discussed. Classification of concomitant adrenal pathologies and proposals on its modification are presented. Relevant literature publications are reviewed and analysed.