We report middle age man with skin hyperpigmentation oral and lip mucous membranes, general malaise and depression. Further examinations lead to adrenal insufficiency, Addison's disease. Imaging studies show bilateral adrenal hyperplasia, show negative result for tuberculosis.We perform laparoscopic adrenalectomy. Multiple caseosa necrosis in gross specimen and Langhan's giant cells microscopic appearance ensure patient suffered Addison's disease cause by adrenal gland tuberculosis.