Adrenal gland surgery has been practiced by the urologists ever increasingly in line with their interest in this particular field. Total adrenalectomy which is the classical approach for adrenal masses, is replaced by the organ-sparing surgery as soon as the significance of the organ sparing approach is understood as in the case of the renal masses. The partial adrenalectomy which has been in use through open surgery method since 1950's, was adapted to adrenal surgery by Gagner in 1991 and technical advancement was achieved since then with the introduction of the laparoscopic adrenalectomy by Janetschek six years later. Although it is increasingly being used, there still exist ambiguities concerning the technique and indications of the adrenal sparing surgery. In this review, the updated status of the adrenal sparing surgery is discussed with the current literature.