Abstract: Objective: To compare the clinical efficacy of open surgery, peritoneal laparoscopic excision and retroperitoneal laparoscopic excision for adrenal pheochromocytoma. Methods:We retrospectively ana-lyzed the clinical data of 54patients with adrenal pheochro-mocytoma (27males and 27females). Patients’age ranged from 19to 71. The diameter of tumors ranged from 1.5 to 7.0 cm. Fifty patients had symptoms of hypertension and their course of disease ranged from 2 months to 15years. None of the patients had inva -sion and metastasis in surrounding organs. According to modus operandi, the patients were divided into 3 groups. The 20patients in group A underwent open surgery, the 16patients in group B underwent peritoneal laparoscopic excision, and the 18patients in group C underwent retroperitoneal laparoscopic excision. The surgical duration, volume of blood loss, severe blood pressure fluctuation, recovery time of intestinal function, postoperative hospital stay, and decrease of blood pressure were compared among the three groups. The re-sults were statistically analyzed. Results: All surgeries were successful, with no complications. All specimens were proved pheochromocytoma. The mean surgical duration was 120 .60± 18.18min in group A,105 .13± 17.46min in group B, and 102 .22± 16.01min in group C. The volume of blood loss was 146 .50± 36.20mL in group A, 116 .56± 37.32mL in group B, and 120 .28± 33.80mL in group C. Twelve cases in group A,5 cases in group B and 5 cases in group C had blood pressure fluctuation. The recovery time of intestinal function was 2.40± 0.79d in group A, 1.75± 0.45d in group B, and 1.58± 0.49d in group C. The postoperative hospital stay was 11.15± 1.87d in group A, 5.94± 0.85d in group B, and 5.94± 0.80d in group C. There was statistical signifi -cance between group A VS group B and group C ( P<0.05). There was no statistical significance between group B and group C. There were 18, 15and 17cases in group A, B and C who had postoperative decrease of blood pressure, with no statistical difference among the three groups ( P>0.05). All cases were followed up for 9 months to6 years, with no recurrence. Conclusion:Peritoneal laparoscopic excision and retroperitoneal laparoscopic excision can be considered as the preferred choice for adrenal pheochromocytoma, with mini -mal invasion, fast recovery, and satisfactory safety.