Abstract: Objective To explore the laparoscopic surgery by retroperitoneal approach in the treatment of complex adrenal tumors. Methods The clinical data of 11 cases with complex adrenal tumors was retrospectively analyzed. There were 4 males and 7 females, with an average age of(48.0±13.0)years, including 4 cases with adrenal myelolipoma, 3 with adrenal pheochromocytoma, 2 with adrenal cysts, 1 with adrenocortical carcinoma and 1 with adrenal ganglioneuroma. The average tumor diameter was(6.5±1.2)cm. Results All the operations were successfully completed. The average operation time was(95.0±15.0)min, blood loss was(50.0±15.0)mL, and the postoperative hospital stay was(4.5±1.3)days. No patient with tumor recurrence was found after 1 year follow-up. Conclusion Retroperitoneal laparoscopic surgery is effective in the treatment of complex adrenal tumors, but it requires experienced physician to operate the laparoscopic surgery so as to safely carry out retroperitoneal laparoscopic surgery for complex adrenal tumors.