Adrenal glands are neuroendocrine organs producing various hormones necessary for body homeostasis. Adrenal cortex produces three major steroid hormones; mineralocorticoids, glucocorticoids and adrenal androgens. Adrenal medulla produces catecholamines, which are crucial for acute responses of the body to both physical and psychological stress. Mineralocorticoids regulate electrolyte balance by increasing reabsorption of sodium and secretion of potassium by renal tubular epithelial cells. The main mineralocorticoid aldosterone, primarily affects total body volume and does not change sodium concentration. Its secretion is mainly regulated by serum angiotensin II or potassium levels. Cortisol, secreted in a circadian rhythm under adrenocorticotrophic hormone (ACTH) control, is the major glucocorticoid. It is crucial for life since it has sophisticated physiologic roles including metabolism, immunity, intravascular volume and central nervous system. Adrenal androgens produced in the zona reticularis are dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS) and androstenedione. In the last decade, inhibition of adrenal androgen production with targeted therapies has shown survival benefits in advanced prostate cancer. Together with the advances in minimally invasive surgical skills and the comfort in retroperitoneal surgical anatomy, it is unavoidable for urologists to have knowledge of the adrenal gland physiology and to follow emerging developments on evaluation and management of adrenal disorders.