Objective To improve the diagnosis and treatment of adrenal tuberculosis. Methods We reviewed the diagnosis and treatment of 3 cases of adrenal tuberculosis in our hospital, and all 3 cases were treated with biochemical, B-ultrasound and CT examinations, anti-tuberculosis and long-term hormone replacement therapy. The results showed that the clinical symptoms of Addison’s disease caused by adrenal tuberculosis were well controlled by anti-tuberculosis and long-term hormone replacement therapy at 1-3 years of follow-up, and the plasma cortisol in the blood biochemical examination was back to near normal range. Conclusion The diagnosis of adrenal tuberculosis can be determined based on clinical features, combined with biochemical and adrenal imaging examinations. Anti-tuberculosis and long-term hormone replacement are the main treatments for adrenal tuberculosis. Clinically, adrenal tuberculosis is rare, and early detection and treatment are important for this disease. From 2000 to 2006, we treated 3 cases of primary hyperaldosteronism (Addison’s disease) caused by adrenal tuberculosis in our hospital. We now discuss the diagnosis and treatment of adrenal tuberculosis with cases and literature review.