Abstract: Objective: To study the clinical effect of retroperitoneal laparoscopic adrenalectomy on adrenal adenoma based on enhanced recovery after surgery(ERAS) concept and its influence on postoperative recovery. Method: A retrospective analysis of 54 adrenal adenoma patients undergoing retroperitoneal laparoscopic adrenalectomy from October 2016 to December 2017 in First Affiliated Hospital of Shanxi Medical University was conducted, and according to whether ERAS concept was applied in perioperative period, the patients were divided into the ERAS group and the traditional control group. ERAS concept was applied in 26 patients during the perioperative period(including posterior approaches) and traditional model was applied in 28 patients(including the anterior approaches). The baseline characteristics, surgical data, complications, postoperative follow-up, the first drinking time after operation, the first flatus after operation, NRS, the first time to get out of bed after operation, time of catheterization, time of drainage, the occurrence of postoperative complications and hospital stay were compared. Result: There was no difference in the sex ratio, average age, BMI, tumor diameter, preoperative blood pressure, preoperative concentration of blood potassium or blood aldosterone between two groups. The patients of the ERAS group had shorter surgery time(P<0.05), less intraoperative blood loss(P<0.05) than patients of the control group. The follow-up showed that the postoperative concentration of blood potassium and blood aldosterone of the two groups improved and there was no difference between the two groups. The first drinking time after operation, the first flatus after operation, the first time to get out of bed after operation, time of catheterization, time of drainage and hospital stay of the patients in the ERAS group were significantly shorter than those in the control group. Patients of the ERAS group had lower gastrointestinal complications than patients of the control group, but there was no difference(P>0.05). The NRS of 4 hours, 24 hours and 48 hours after operation of the ERAS group showed no difference with those of the control group(P>0.05). No complications such as wound infection or delayed bleeding occurred in the two groups.Conclusion: Compared with the traditional treatment model, retroperitoneal laparoscopic adrenalectomy based on ERAS concept was effective in treating adrenal aldosterone tumor and could shorten surgery time, reduce intraoperative and postoperative bleeding, relieve postoperative pain and improve the early recovery of gastrointestinal function and thus reducing bedridden time without increasing postoperative complications.