Adrenocortical carcinoma is a rare cancer with poor prognosis. We report a case of metastatic adrenocortical carcinoma in a 61-year-old man successfully treated with multimodal therapy. A left adrenal tumor was detected incidentally in the patient and an adrenalectomy was performed. The pathological diagnosis was adrenocortical carcinoma, stage II. After 1 year, multiple local recurrences were detected in the retroperitoneum space. The patient underwent a metastasectomy and received three courses of adjuvant chemotherapy consisting of etoposide, doxorubicin, and cisplatin plus mitotane. No obvious recurrence has been observed in the 60 months since the treatment.