The adrenal glands are paired glands located above the kidneys and secrete hormones that are important for the normal functioning of the body. With the frequent use of radiological diagnostics, the incidence of adrenal gland tumors has increased due to their accidental detection. Adrenal gland tumors represent a significant medical problem due to different clinical presentations and possible serious consequences. Surgical removal of these tumors plays a major role in the treatment and improvement of patients' quality of life. Also, these tumors represent a challenge for surgeons due to their anatomical localization, possible invasiveness and the presence of malignant cells. The procedure to surgically remove the adrenal gland is called an adrenalectomy, and there are several surgical approaches and methods of adrenalectomy. Open adrenalectomy is performed in patients with suspected malignancy, adrenocortical carcinoma or malignant pheochromocytoma. Laparoscopic adrenalectomy is indicated for the treatment of small to medium-sized (≤6 cm) benign tumors of the adrenal gland, and its advantage is faster recovery due to less blood loss and less postoperative pain and shorter hospital stay. Today, robotic adrenalectomy is also offered as a surgical approach, but it is still not so common due to the high cost of the procedure. Surgical treatment depends on various factors such as tumor type and size, malignancy, presence of metastases, and the patient's health status, and understanding current approaches, their advantages, and limitations is essential to optimize treatment and improve long-term patient outcomes.