Objective：To summarize our experience on laparoscopic adrenalectomy.Methods: From August 2001 to Jun 2007, a total of 203 patients (128 male and 75 female, aged 2174 years, with a mean of \[45±2\] years old) received laparoscopic adrenalectomy. Six patients had bilateral tumors. The diameters of the adrenal tumors or nodules were 0.418 cm. Results: The 203 patients received a total of 209 times of laparoscopic adrenalectomy: including 34 cases via transperitoneal approach, 166 via retroperitoneal approach and 3 via handassisted approach. The overall successful rate of laparoscopic adrenalectomy was 97.04% (197/203). Six persontimes (2.96%) were converted to open operation due to bleeding or adhesion. The mean operation time was 135±35 min and the estimated blood loss was 40250 ml (with a mean of 75±25 ml). The patients could get down the bed for activity 13 days after operation. The postoperative hospital stay was 710 days (with a mean of 7±2 days). The complications included vena caval injury (1 case), pleural injury (1 case), lumbar hematoma (4 cases), and fat liquefaction (1 case).Conclusion: Laparoscopic adrenalectomy has advantages for treating adrenal tumors. But different approaches should be chosen according to the size and pathological types of the tumors. Transperitoneal approach should be chosen for patients with larger tumors, for obese patients or for patients with bilateral lesions.