Objective To evaluate the feasibility , safety, therapeutic effects and adverse reactions of CT-guided radiofrequency ablation (RFA)for adrenocortical adenoma with Cushing's syndrome.Methods From Jan.2009 to Dec.2013, 24 patients with 24 tumors diagnosed as adrenocortical adenoma with Cushing's syn-drome received CT-guided percutaneous RFA.The average tumor size was(2.1 ±0.7)cm(ranging from 1.1 to 3.9 cm) .RFA was performed under real-time computed tomography guidance .Technical success was defined as disappearance of tumor enhancement on contrast CT imaging 1 week after RFA .Clinical success was defined as improvement in serum cortisol, adreno-cortico-tropic-hormone(ACTH)and symptoms within the follow-up.Patho-logical diagnosis was acquired through the needle biopsy after RFA procedure .Results RFA was technically successful in all the 24 patients.No conversion occured.During operation, patients suffered blood pressure fluc-tuation but no one experienced a hypertensive crisis .Mild postoperative lumbar pain occurred in 6 patients . Tumor enhancement disappeared in CT scan .The mean follow-up was 18 months, ranging from 3 to 36 months. Both serum cortisol and ACTH basically returned to normal levels , and the symptoms related to Cushing's syn-drome gradually disappeared .No severe complications occurred during this procedure .Histopathology results showed all were adrenal cortical adenomas .No serious complication occurred to any patient during RFA .Conclu-sion CT-guided RFA for adrenocortical adenoma with Cushing's syndrome is a feasible , safe, effective and mini-mally invasive treatment with few complications .