Objective To investigate the CT and pathological findings of adrenal myelolipoma， so as to improve the accuracy of diagnosis. Methods CT manifestations of twelve cases with pathological documented adrenal myeloli-pomas were retrospectively analyzed. Combined with pathological features， the location， size， shape， density， and surro-unding structures of adrenal myelolipomas were evaluated on CT image， respectively. Results Of 12 cases with adrenal myelolipomas， 9 cases arose from right adrenals， 2 cases from the left，and 1 case involved bilateral adrenal glands. CT features delineated the mixed density masses arising from adrenals， but majority components were fat densities. Pathological examination demonstrated the tumor was composed of mature fat cells and bone marrow cells. Compared with pathologic results， preoperative CT diagnosis was reliable for significant accuracy （11/12）. Conclusions Adrenal myelolipoma is rare. Combined with pathological characteristics clinical findings and laboratory tests， adrenal myelolipoma can be corr-ectly diagnosed with CT examination.