Objective: Sensitivity and specificity of endocrine dynamic tests for confirming definitely diagnosis of primary aldosteronism (PA) is very important after screening low reninemic hyperaldosteronsm. We investigated the results of endocrine dynamic tests such as furosemide + upright test (Fu), captopril challenge test (Cp), saline infusion test (Si), and rapid ACTH loading test (Ac) in the patients of PA who simultaneously underwent super-selective ACTH-stimulated adrenal vein sampling (SS-ACTH-AVS). Our newly developed method of SS-ACTH-AVS has very high potential in diagnosis of PA and can also detect precisely adrenal lesions, including CT-undetectable mass. Method: We analyzed 100 PA-patients, including 62 patients of aldosterone producing adenoma and 38 patients of idiopathic hyperaldosteronism who were diagnosed by SS-ACTH-AVS and all tests of Fu, Cp, Si, Ac were done in those cases. We investigated sensitivity of each endocrine dynamic test by using each cut off value, according to the guidelines of the Japan Endocrine Society (Endocrine Journal 2011, 58 (9), 711–721). Concerning about Ac, we judged positive when the ratio of maximum plasma aldosterone concentration (pg/ml) to cortisol (μg/dl) after ACTH stimulation is observed as > 8.5. Result: Sensitivity of Fu, Cp, Si, Ac were 83%, 69%, 79%, 98% respectively. There were 14 patients who judged negative in both of Cp and Si. But 87% of the patients were judged as positive in more than 2 tests of 3 tests such as Fu, Cp, Si. Conclusion: Ac has the highest sensitivity among endocrine dynamic tests for PA, suggesting that Ac is the most useful confirmatory test. Fu had shown the second highest sensitivity among them. Cp and Si did not show better sensitivity, and it is supposed that Cp and Si are not always suitable for establishing definite diagnosis of PA. Thus, we can diagnose 87% of PA, if there are more than 2 positive tests in 3 tests such as Fu, Cp, Si.