The complications of adrenal surgery can be divided into preoperative errors in planning, operative complications, and those seen in the peri- and postoperative period. Long-term complications are also observed secondary to the loss of adrenal function and patients may require permanent replacement therapy. With correct preoperative planning, many of these complications can be lessened or ultimately avoided. The evaluation of Cushing’s syndrome frequently identifies surgically amenable lesions in the pituitary or adrenal gland. To correctly diagnose the etiology, several tests are useful including urinary cortisol measurements, dexamethasome suppression tests, and measurement of Adreno corticotropic hormone. A common complication of open adrenal surgery is entry into the pleural cavity seen during a supra-eleventh rib approach. A chest tube can be placed directly into the chest cavity during closure to protect against pneumothorax. Pheochromocytoma patients may require invasive monitoring in an intensive care unit setting for cardiovascular monitoring.