Adrenal myelolipoma is a rare benign tumor composed of mature adipose cells and hematopoietic elements. Although they are not hormonally active, there is very rarely an association with functional adrenal disorders. We report a case of bilateral adrenal myelolipoma associated with primary hyperaldosteronism. To our knowledge, this is the first bilateral adrenal myelolipomas reported to date in association with primary hyperaldosteronism.