Objective To compare the surgical efficacy of da Vinci robot-assisted laparoscopy and traditional laparoscopy in the treatment of complicated adrenal tumors, so as to explore the clinical prospects of da Vinci robot-assisted laparoscopic surgery for the diseases. Methods The clinical data of 47 patients with complicated adrenal tumors who were admitted to Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from Mar. 2016 to Mar. 2019 were collected, with 25 cases in robot-assisted laparoscopy group and 22 cases in traditional laparoscopy group. The two groups were compared in terms of conversion to open surgery, operation time, intraoperative blood loss, postoperative drainage tube drawing time, hospital stay and hospitalization expenses. Results The surgery was successfully completed in robot-assisted laparoscopy group, while there were two cases of conversion to open surgery in traditional laparoscopy group. The differences in operation time between the robot-assisted laparoscopy group and traditional laparoscopy group were not statistically significant (159 [149, 168] min vs 165 [155, 194] min, P>0.05). Compared with traditional laparoscopy group, robot-assisted laparoscopy group had significantly less intraoperative blood loss (350 [250, 475] mL vs 550 [285, 615] mL, P<0.05], earlier drainage tube removal (3 [3, 4] d vs 4 [3, 4] d, P<0.05) and shorter hospital stay (6 [6, 7] d vs 7 [7, 8] d, P<0.05). However, hospitalization expenses in robot-assisted laparoscopy group were significantly higher than those in the traditional laparoscopy group (72 874.30 [72 398.60, 73 651.60] yuan vs 48 933.50 [43 978.60, 50 254.90] yuan, P<0.05). Conclusion Da Vinci robot-assisted laparoscopy has its own advantages in the treatment of complicated adrenal tumors, which is worthy of promotion in patients who can afford.