In India, lung cancer accounts for approximately 5.1% of all prevalent cancers and causing 8.9% cancer related mortalities. (1) Major subtypes of lung cancers prevalent in the country include NSCLC - Adenocarcinoma subtype (34%) which is followed by Squamous cell variant (28%), while 16% correspond to small cell variant. (Mohan et. al 2020).(2) The presence of adrenal metastasis in lung cancer equals disseminated disease where patient prognosis is poor, with overall survival rates corresponding to 30 months and a median survival rate of 31%, while an early diagnosis and surgical resection can improve patient outcome by 125 months. Adrenal metastasis to lung cancer can occur by lymphatic or hematogenous route. Ipsilateral metastasis occurs by the lymphatic route which follows Markov Newton chain model (3) following the retroperitoneal lymphatics. This corresponds to the lesser aggressive variant, while hematogenous route predominantly is associated with contralateral adrenal being affected, and remains more aggressive as contralateral adrenal metastasis implies distant dissemination.(4) According to Ivana et.a(5), 80% of NSCLC variants are seen metastasizing to adrenals, while only 30% of Small cell variants cause adrenal metastasis. Bilateral adrenal metastasis were seen only in 3% of all cases (Navneetsingh)(6)