Objective To analyze the effect of laparoscopic adrenalectomy on blood pressure in patients with adrenal hypertension, and to explore the related influencing factors of postoperative hypertension, so as to improve the clinical effect of the treatment of adrenal hypertension. Methods The clinical data of 100 patients with adrenal hypertension and laparoscopic adrenalectomy screened in the Second Affiliated Hospital of Guangdong Medical University from January 2021 to December 2023 were retrospectively analyzed. They were divided into a normal blood pressure group （n=50） and a hypertension group （n=50） according to blood pressure. All patients received adrenal CT examination, primary aldosteronism （PA） screening test, and adrenal venous blood sampling （AVS）. After half a year of follow-up, the general information, preoperative and postoperative blood pressure, antihypertensive drug use, blood potassium level, aldosterone level of the patients were collected, and the differences between the normal blood pressure group and the hypertension group were analyzed. Results The patients in the hypertension group were mostly male, with smoking history, drinking history, high body mass index （BMI）, bilateral tumors, PA and pheochromocytoma, large tumor, long operation time, large intraoperative blood loss, and poor medication compliance. Before operation, there was no significant difference in blood pressure, serum potassium level, and recumbent aldosterone level between the two groups （P>0.05）.Half a year after operation, the diastolic blood pressure, systolic blood pressure, and recumbent aldosterone levels in the normal blood pressure group were lower than those in the hypertension group, and the serum potassium was higher in the normal blood pressure group （P<0.05）. Multivariate analysis showed that the patients who were elderly, high BMI, smoking history, drinking history, bilateral tumors, PA and pheochromocytoma in tumor tissue, and poor medication compliance had a higher risk of postoperative hypertension （P<0.05）. Conclusion Laparoscopic adrenalectomy has a significant impact on the blood pressure of patients with adrenal hypertension. The control of postoperative hypertension is related to a variety of factors, including age, BMI, smoking history, drinking history, the location and number of tumors, and medication compliance. Therefore, for these high-risk patients, postoperative monitoring and personalized management should be given more closely.