Background: Adrenal masses are a common finding in the adrenal gland. Steroidogenic factor 1 (SF1) is a nuclear transcription factor that regulates genes involved in gonadal and adrenal steroidogenesis. Ghrelin is a ligand of growth hormone secretagogue receptor type 1 (GHS-R1). The principal role of ghrelin is to regulate energy homeostasis and secretion of growth hormone. Aim: to differentiate adrenocortical adenoma, carcinoma and pheochromocytoma immunohistochemically using steroidogenic factor-1 (SF-1) and gherlin expression and evaluate their diagnostic and prognostic significance in relation to various clinicopathologic parameters.Material and methods: This is retrospective study carried upon 45 of different cases of adrenal gland lesions designated as: 20 cases of adrenocortical adenomas(ACA) and 10 cases of adrenocortical carcinomas(ACC) and 15 cases of pheochromocytoma . Immunohistochemical staining techniques were used to detect the role of SF-1 and gherlin in the forementioned adrenal gland lesions and evaluate their relations to different clinicopathological data and patient’s survival.