The diagnosis of adrenocortical carcinoma mainly relies on imaging and functional examinations. The recommended examination item is CT plain scan intensification. The CT performance of adrenocortical carcinoma is special, one is larger in size; rather, the density is inhomogeneous, with obvious enhancement in parenchymal areas and insignificant enhancement in non-parenchymal areas such as cystic suggesting necrosis. About 40% of the tumors can be seen as calcified foci. Because of the large size of tumor, it often invades or compresses the surrounding organs and obstruction, such as ipsilateral kidney, inferior vena cava and splenic vessels. If the adjacent vessels are causing compression, MRI can be considered to clarify the degree of vascular compression. Puncture biopsy is generally not recommended.