In this article the pre-operative, intraoperative, and post-operative management of patients with pheochromocytoma, aldosterone-producing adenoma, cortisol-producing tumors, and adrenal cortical carcinoma are reviewed. A detailed plan for pre-operative assessment and medical optimization is discussed. The potential intraoperative and post-operative complications that occur in patients with an adrenal tumor are reviewed with emphasis on recognition, treatment and prevention. Recommendations for anesthetic management, intraoperative and post-operative monitoring, blood pressure management, laboratory analysis and medication adjustments are presented.