Adrenocortical tumors are rare and mostly non-secreting; their discovery is incidental. When secreting, they produce steroid excess and result in a clinical presentation such as the Cushing syndrome, primary aldosteronism, virilization or feminization syndrome. Such tumors are mostly sporadic but can belong to hereditary syndromes predisposing to tumors. The diagnosis of secreting adrenocortical tumors is based upon clinical presentation and biological data associated with specific biological assessments. Adrenal imaging has been considerably improved with the development of CT scan, which can be completed by MRI if necessary. Most of adrenocortical tumors are adenoma, nevertheless some of them can be malignant and the prognosis of such carcinomas is poor. Management of secreting adrenocortical tumors requires surgery in most of the cases and laparoscopic access is now widely used and provides good results in the treatment of benign tumors.