The prevalence of adrenal tumors is 523 per 100,000 inhabitants, with significantly higher rates among the elderly. Comprehensive therapeutic plans are essential for addressing tumoral lesions. Nontumoral processes, such as adrenal hyperplasia and cyst, may also require surgical interventions particularly when resistant to medical treatments. Surgical adrenalectomy is the choice of treatment for adrenal tumors and refractory nontumoral processes. In the 1990s, percutaneous chemical ablation of adrenal tumors emerged as an alternative therapy. However, it was largely replaced by thermal ablation modalities, including radiofrequency ablation, microwave ablation, and cryoablation. Percutaneous adrenal ablation is generally considered safe, with a few adverse events reported. Although comparative studies are limited, the oncological and hormonal outcomes of successful ablation are promising. A successful adrenal ablation, nevertheless, requires a multidisciplinary collaboration to prevent and manage potential ablation-induced hypertensive crises. This chapter provides an overview of the anatomic considerations and common indications for adrenal ablation, followed by a detailed discussion of technical aspects, including pre-ablation preparation, procedural steps, post-ablation follow-up, and potential adverse events. The chapter concludes with an exploration of future trends and advancements in adrenal ablation.