Abstract Background: Since Gagner performed the first laparoscopic adrenalectomy in 1992, laparoscopy has become the gold-standard procedure in the treatment of adrenal surgical diseases. Literature indicates that the rate of intra- and postoperative complications are not negligible. This study aims to describe the single-center experience of adrenalectomies; and explore the associations between body mass index (BMI) and tumor volume in main postoperative outcomes. Methods: Retrospective observational study with a prospective database in which we described patients who underwent adrenalectomy between January 2015 and December 2020. Operative time, intraoperative blood loss, conversion rate, complications, length of hospital stay, and comparison of the number of antihypertensive drugs used before and after surgery were analyzed. Analysis of BMI and tumor volume with postoperative outcomes such as anti-hypertensive change (AHC) in drug usage and pre-operative conditions were performed. Results: 45 adrenalectomies were performed, all of them were carried out laparoscopically. 4 were performed as a robot-assisted laparoscopy approach. 19 were women and 26 were men. Mean age was 54.9 ± 13.8 years. The mean tumor volume was 95.698 mm3 (Range 3.75 - 1010.87). Mean operative time was shorter in right tumors (2.64 ± 0.75 hours ) than in left tumors (3.33 ± 2.73 hours). Pearson correlation was performed to assess the relationship between BMI and AHC showing a direct relationship between increased BMI and anti-hypertensive drugs usage decrease r(45)= 0.92, p > 0.05 CI 95%. Operative time, Higher tumor volume showed a longer operative time, r(45)=0.6 (p=0.000 CI 95%). Conclusions: Minimally invasive adrenalectomy appears to have an increased impact in patients with higher BMI in terms of postoperative anti-hypertensive usage. Tumor volume seems to be associated with higher operative time and blood loss leading possibly to increased rates of morbidity. Nevertheless, due to our limited number of patients, more studies are needed to replicate and validate these results.