Adrenal tumors include both benign and malignant neoplasms arising from either the adrenal cortex or medulla. Many are identified incidentally and require a full evaluation including history, physical, imaging, and biochemical analysis. A complete functional evaluation will include an assessment of autonomous cortisol secretion, primary aldosteronism, and catecholamines. Management differs based on imaging characteristics, concern for malignancy, and functional profiles.