Background: Laparoscopic adrenalectomy has emerged as the standard treatment for adrenal tumors. Although the application of high - resolution cameras has enhanced visualization in conventional two - dimensional laparoscopy, it has not fully overcome the limitations of depth perception and spatial recognition. However, thanks to significant advancements in three - dimensional technology in laparoscopic surgery, these issues have been totally solved. This study aims to evaluate the outcome of three - dimensional laparoscopic adrenalectomy. Methods: A prospective study included 38 patients with adrenal tumors who underwent three - dimensional laparoscopic adrenalectomy from April 2020 to December 2022 at the Department of Urology, Hue Central Hospital. Results: The mean age was 42.5 ± 5.1 years old. The most common reason for hospitalization was back pain, accounting for 39.5%. Adrenal incidentalomas were detected in 23.7% of patients. The proportion of patients with functional adrenal tumors was 55.3%; nonfunctioning adrenal lesion with progressive growth 13.1% and pheochromocytoma was 7.9%. Computed tomography showed a mean tumor size of 30.5 ± 9.2 mm. The mean operative time was 108.8 ± 12.3 minutes. There were no cases of intraoperative complications or conversion to open surgery. Early postoperative complications include wound infection (5.3%) and fluid accumulation (2.6%). The mean postoperative hospital stay was 5.5 ± 1.9 days. Postoperative pathological reports showed adrenocortical tumors in 81.6%. At follow - up, 35 of 38 (92.1%) cases were asymptomatic and had normal follow - up results in laboratory tests. Conclusions: Three - dimensional laparoscopic adrenalectomy is a minimally invasive, safe, and effective method.