IntroductionPrimary aldosteronism (PA) is the leading cause of endocrine hypertension, with an estimated prevalence of at least 5 to 10% among patients with hypertension and more than 20% among patients with resistant hypertension [1–3]. PA enhances the risk of renal and cardiovascular morbidity and mortality via direct insults to target organs, independently of hypertension [4]. Broadly, PA can be dichotomized to unilateral aldosterone production from the right or left adrenal gland (aldosterone-producing adenoma) or bilateral hyperaldosteronism [5].In contrast to primary aldosteronism, pheochromocytomas are rare, mostly benign catecholamine-producing tumors of chromaffin cells of the adrenal medulla or of a paraganglion with typical clinical manifestations of sustained or paroxysmal hypertension, severe headaches, palpitations, and sweating resulting from hormone excess [6,7]. Pheochromocytomas are found in 0.2-0.6% of subjects with hypertension, while most patients (80 – 90%) with pheochromocytoma have hypertension [8–10].The simultaneous occurrence of pheochromocytoma and aldosterone-producing adrenal cortical adenoma is rare and presents diagnostic and therapeutic challenges. The clinical manifestations can be complex, as patients may experience symptoms from both tumors, including hypertension and endocrine abnormalities. The diagnostic process typically involves hormonal assays and imaging studies such as computed tomography to characterize the tumors. The most definitive treatment for both conditions is surgical removal of the affected adrenal gland. This can lead to the cure of hypertension due to aldosteronism and/or pheochromocytoma.In this case report, we describe the rare coexistence of pheochromocytoma and aldosterone-producing adrenal cortical adenoma in a young Ethiopian male presenting with hypertension, which was ultimately cured by unilateral total adrenalectomy.