Proper treatment of resection specimens by the urologist and pathologist is critical in accurately reporting tumors and tumor-like nodules of the adrenal gland. Clinically inapparent adrenal masses are discovered, with increasing frequency, in the course of diagnostic testing or treatment for conditions that are not related to adrenal diseases. As a consequence an increasing number of relatively small tumors lacking the characteristic gross features of malignancy is detected. There is a need for identification of pathological findings that can improve the diagnostic accuracy and predict patient outcome. The aim of this paper is to review the handling and pathology reporting of adrenal gland specimens in the light of recent advances in this field of pathology.