Abstract: ObjectiveTo explore the vascular treatment in retroperitoneoscopic resection of adrenal tumor. Methods: The adrenal tumors in 32 patients were resected by retroperitoneoscopy.The adrenal gland and tumors were dissociated above the kidney during the operation， the superior，middle and inferior adrenal arteries were treated with ultrasonic knife and titanium clips， the adrenal central veins were dissociated and ligatured( the right adrenal central vein was dissociated along the surface of the inferior vena cava， the left adrenal central vein was dissociated along the edge of the adrenal glands and the upper pole of the kidney) .The adrenal and the tumor were completely resected.Results: All operations in 32 cases were successful， the amount of bleeding loss was 10 to 150 ml.The right adrenal central vein of 1 case poured into the right side of the inferior vena cava.The right adrenal central vein of 1 case divided into two branches， the head and foot side of which were thin and thick，and poured into the right hepatic vein and inferior vena cava，respectively. Conclusions: Mastering the vascular anatomy and variations of adrenal glands and correct treatment can effectively prevent the intraoperative bleeding in retroperitoneoscopic resection of adrenal tumor.