The wider application of radiological examinations (ultrasound, computed tomography) has led to the pre-clinical discovery of "masses" in some organs, especially in adrenal gland. As these tumors are incidentally discovered, they are called "incidentalomas", and this term has been universally accepted. As soon as adrenal incidentaloma has been diagnosed it is important to establish if the patient has to undergo immediate surgical exploration or it is possible to follow the patient radiologically. Hormonally active adrenal metastatic tumors and adrenal incidentalomas greater than cm 5 should be surgically treated, while other adrenal tumors can be followed radiologically. Median anterior laparotomy or bilateral subcostal incision give a good surgical view. It is important the cooperation with endocrinologist, cardiologist and anaesthetist in order to control possible hypertensive rises during surgical operation.