Introduction: Adrenal cell carcinoma (ACC) is a rare malignancy and often presents in the advanced stages. Clinical presentation varies depending on the type of ACC and whether the tumour is functional or non-functional. We report our experience with ACC encountered over seven years (2005 to 2011). Material and Methods: All patients diagnosed and treated for ACC in our institutions were identified and data collected were collected and retrospectively analysed. Diagnoses of ACC were made based on: histology, combination of imaging and laboratory investigations. Results: There were seven patients (Chinese, n=5 and female, n=4) with a median age of 39 years old (range 17 to 52) treated at our institution during this period. Four patients had functional cortisol producing tumours. In most, radical surgery was carried out with mitotane used as adjuvant therapy. Hypercortisolism was controlled using mitotane in most, and etomidate in one case. In the other three patients with non-functional tumours, the tumours were generally large at presentation and diagnosis. Conclusion Although the overall prognosis of ACC is limited, the prognosis of the functional tumours is influenced by the success in re- ducing hormonal excess, whereas, in the non-functioning type, radical surgery seems to prolong sur- vival.