Incidentaloma, a modern concept connected to technology progress, represents an accidentally discovered tumour, usually used for hypophysis and adrenals, and rarely for thyroid, parathyroids, and ovaries. This is a narrative review based on PubMed research, between 2012 and 2016 focusing on general and endocrine approach and current controversies. Main dilemma is the terminology itself: randomly imagery finding is enough or non-functioning profile and lowgrowth rate (not requiring surgery) should be mandatory? The controversies refers to best time framing of rescanning pituitary and adrenal incidentaloma and setting of clear criteria for subclinical Cushing's syndrome. The need for general practical guidelines is imperative so clinicians from different areas of medicine touse the same definition and protocols. Currently, the widely accepted part is represented by incidental finding. For restricted defined incidentaloma the best intervention is no intervention, while some cases may require surgery depending on tumours features, patient's age and preference.