Adrenal incidentalomas refer to incidentally discovered adrenal masses during radiological examination for other reasons. Such findings have only been rarely reported in pregnancy due to predominant use of ultrasound rather than Computed Tomography (CT) in a pregnancy setting. The main concerns of such incidentally discovered adrenal masses in pregnancy are whether they are functioning or malignant. Evaluation of functionality presents its own set of challenges due to physiological changes that occur during pregnancy. Any adrenal mass greater than 4 cm raises the suspicion of malignancy as well. We report a rare case of a 7 cm left adrenal incidentaloma in pregnancy and the associated dilemmas in management of such a presentation.