OBJECTIVES: The excision of the adrenal gland by laparoscopic approach is the gold standard for the treatment of adrenal tumors smaller than 6 cm. Most Brazilian centres favour the transperitoneal approach. The objective of the present prospective study was to show the intraoperative and postoperative results ofpatients undergoing adrenal laparoscopic surgery through a lateral retroperitoneal approach performed by an individual surgeon.METHODS: Between January 2000 and October 2004, 35 patients (16 males and 19 females) with adrenal lesions, including 4 Cushing’s syndrome, 4 Conn’s syndrome, 1 neuroganglioma, 4 pheochromocytoma,17 nonfunctioning adenomas,1 virilizing tumor, and 4cases of adrenal nodule after treatment of a non-adrenal primary neoplasia, prospectively underwent retroperitoneoscopic adenomectomy by one surgeon. We describesurgical times, estimated blood losses, time to oral intake,analgesic requirements, surgical complications andconversion rates, hospital stay and time to return to usual activities, comparing our results with other series in the literature.RESULTS: All procedures were successfully completed. Mean surgical time was 135 minutes, mean estimated blood loss 235 ml, mean time to oral intake 12 hours, no patient required analgesics after the second postoperativeday, mean hospital stay was 2 days, and mean time to return to usual life activities 3 weeks. There were two complications, one case of intraoperative hypercapnia and one case with postoperative pneumonia. Conversionto open surgery was not required in any case.CONCLUSIONS: Retroperitoneoscopic adrenalectomy may be performed effectively and safely, with a low complication rate, independently of the etiology of the lesion. The lateral retroperitoneoscopic access is anexcellent option for the minimally invasive treatment of the adrenal glands.