Traditional open adrenal surgery is difficult to expose the adrenal gland because of the high incision position, easy damage to the pleura, and poor exposure of the operative field. The use of laparoscopy, especially the retroperitoneal route for adrenal surgery, not only reduces surgical trauma, but also allows better exposure of the adrenal glands, with clear intraoperative anatomy and far less bleeding and complications than open surgery. By comparing the two procedures, posterior laparoscopic adrenal surgery is superior to open surgery in terms of operative time, postoperative hospital days, average intraoperative bleeding, and complication rate. As with transurethral electrodesiccation of the prostate for prostatic hyperplasia, posterior laparoscopic adrenalectomy is quickly becoming widely promoted as the gold standard for adrenal surgery with its unprecedented rate of development. With the application of needle-shaped laparoscopy, laparoscopic adrenal surgery has developed in a more minimally invasive direction; the application of robotic hands in laparoscopic surgery has made the operation more delicate and accurate; the application of other knives such as ultrasonic knife and plasma knife has made adrenal freeing more convenient; the application of 3D imaging system has made the surgical field more clear and three-dimensional; far-infrared camera and ultrasonic detection head can help the operator to detect The location of blood vessels to reduce intraoperative bleeding. In conclusion, laparoscopic adrenalectomy will become more mature as the urologists become more proficient and improve their laparoscopic techniques, and with the help of advanced equipment and instruments.