Abstract Objective: Adrenal metastases are frequently encountered during autopsy but uncommonly present clinically. The aim of this study was to evaluate the clinical and pathological impact of adrenal metastases in a large series of patients. Patients: Four hundred and sixty-four patients (288 men, 176 women) with metastatic disease in the adrenal glands over a 30-year period were included in the study. Measurements: The clinical records and pathological features were reviewed.