A case report of primary adrenal lipoma is being presented. A 35-year-old male, initially presented with pain in right loin and was admitted to Urology Unit of Prince Abdullah Bin Abdul Aziz Hospital, Bisha, KSA, for frank hematuria. The tumour was suspected on IVU and ultrasound abdomen and confirmed on CT-scan of abdomen. Right adrenalectomy was successfully performed and histopathology confirmed the diagnosis of adrenal lipoma.