Abstract: Obstract : To evaluate the favourable strategy for diagnosis and treatment of the adrenal incidentalomas. Methods : A total of 50 cases with adrenal incidentaloma, from 2002 to 2004,were analyzed. Results : Total resection was performed in all cases, of which 31 were treated by trans-abdominal operation, ten cases by translumbar operation and nine by laparoscopicsurgery. Of all types of the adrenal incidentalomas, 31 were adenomas, two adrenal carcinomas, eight heochromocytomas,three adrenal gland cysts, one myelolipoma, one ganglioneuroma and one adrenal metastatic carcinoma. Conclusion : Before operation, the routine endocrine examinations should be taken in all adrenal incidentalomas. The ultrasoun-B, CT scanning and MRI are of high value in ascertaining an adrenal tumor.Early surgical operation should to be performed except for the adrenal gland cyst and myelolipoma,which were less than 3.0 cm in size. The first option is laparoscopic surgery. The transabdominal operation should be undertaken for tumors with greater diameter and suspected malignancy.