In about 10% of hypertensive patients the cause of elevated blood pressure is primary hyperaldosteronism, which is more commonly induced by bilateral adrenal hyperplasia or adrenal adenoma. Consistent overproduction of aldosterone leads to the development of renal impairment and increases the risk of cardiovascular diseases and death. The main blood test to diagnoose the condition is the aldosterone/renin ratio. In addition, adrenal computed tomography should be done. The presence of a unilateral form of primary hyperaldosteronism should be established or excluded by bilateraal adrenal venous sampling. In patients with aldosteroma, unilateral laparoscopic adrenalectomy is the treatment of choice.