Adrenal hemangiomas present a significant diagnostic challenge due to their rarity and overlapping imaging features with more commonly encountered adrenal tumors, such as pheochromocytomas. In this article, we present imaging characteristics of adrenal hemangiomas and differentiate them from pheochromocytomas and other adrenal neoplasms with similar radiologic appearances. This article is based on real clinical conundrum that the authors aim to share with readers.