Adrenal myelolipoma is a rare nonfunctioning tumor consisting histologically of an admixture of adipose tissue and extramedullary hemopoietic elements within the adrenal glands. Most of these lesions are 5 small and asymptomatic, but there are also giant ones, associated with endocrine disorders. These tumors are mostly detected incidentally by imaging. The increasing number of incidentally discovered adrenal myelolipomas arise the question of appropriate treatment modalities. The authors report a case of giant myelolipoma associated with lithiasic cholecystitis and discuss different imaging and terapeutic aspects.