BACKGROUND Earlier reports of laparoscopic adrenalectomy (LA) for adrenal myelolipoma are limited. METHODS Between June 2000 and September 2012, we performed right adrenal resections using LA and open adrenalectomy (OA) in patients with myelolipoma (n = 3 and n = 3, respectively). Then, we evaluated patients' background characteristics and short- and long-term outcomes for both groups. The median maximum diameters of tumors were 3.5 (3.0-4.4) cm and 7.1 (7.0-9.5) cm for the LA and OA groups, respectively. The median durations of the operation were 152 (117-188) min and 218 (153-230) min, and the median blood loss volumes were 50 (20-160) mL and 290 (62-1237) mL in the LA and OA groups, respectively. The median postoperative lengths of hospital stay were 4 (4-4) days and 11 (11-13) days for the LA and OA groups, respectively. Conversion from LA to an open approach during surgery was not necessary in any of the cases. Additionally, perioperative morbidity and mortality were not observed. CONCLUSIONS The limitation of this study is its methodological design; it is a case series and not a matched-control study, which would be difficult to conduct owing to the rare nature of adrenal myelolipoma. However, we esteem that LA will become widespread in the future because it is feasible, cosmetic, and less invasive. CONCLUSIONS LA was a safe, feasible, and effective approach to adrenal myelolipoma, assisted by advancement in preoperative imaging diagnostic techniques.