Objective: Conn's adenoma is a rare cause of high blood pressurr. It is the second surgically curable cause of hypertension after renal artery stenosis. Its recurrence after surgery remains rare. Design and method: We report a case. Results: Mr B.M, 60 years old, with a history of diabetes, hypertensive and right adrenalectomy for Conn's adenoma, admitted for investigation of dysphagia and high blood pressure. On examination, the blood pressure was 17/10, the pulses are present and symmetrical. Skin examination revealed sclerodactyly, subcutaneous calcinosis and raynaud's syndrome. The blood ionogram showed hypokalaemia while the renal workup noted chronic renal failure. Urinary cortisol and plasma cortisol were normal. The adrenal CT scan showed a left adrenal nodule. A contralateral recurrence of Conn's adenoma associated with CREST syndrome was strongly suspected. The decision was to intensify the antihypertensive treatment. Conclusions: Hypertension can be multifactorial: metabolic syndrome, Conn's adenoma and systemic disorder. A recurrence of an operated Conn's adenoma should be systematically sought in the presence of persistent elevated blood pressure levels.