Aldosterone-producing adenomas account for approximately 0.5% of all cases of hypertension. The incidence of aldosterone-producing adenomas during pregnancy is much lower, as reflected by a total of 15 biochemically and pathologically confirmed case reports in the English literature. We report the diagnosis, surgical management, and outcome of a patient with an aldosterone-producing adenoma suspected at 20 weeks gestation. Uniquely, we document the biochemical profiles of aldosterone, plasma renin activity, and 18-hydroxycorticosterone before and after surgical resection of the aldosterone-producing adenoma and 6 weeks postpartum. Our case and compilation of the English literature demonstrate an historic trend toward enhanced confidence in diagnostic testing during pregnancy and, subsequently, early surgical referral.