Adrenal hemangiomas are rare non-functioning tumors that originate from the retroperitoneal organs. They are generally asymptomatic, and are usually discovered at autopsy. In 1955, Johnson and Jeppensen reported the first case of a surgically removed adrenal hemangioma. We report a case of adrenal hemangioma that mimicked a pancreatic tail tumor, as detected by computed tomography. We made a diagnosis of an adrenal hemangioma from endoscopic ultrasonography and confirmed the diagnosis following a laparascopic adrenalectomy. If one is suspicious of an adrenal hemangioma, one needs to assess the lesion from every aspect. With the advancement of diagnostic techniques in arteriography, ultrasound, and computed tomography, the frequency of preoperative recognition and diagnosis is on the increase. Still, it is difficult to diagnose an adrenal hemangioma just from an imaging study. One should consider performing surgery for removal of the tumor to rule out a malignancy, and to prevent traumatic rupture. With the case presentation, we review the clinical, radiographic, and pathological features of adrenal hemangiomas.