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Adrenal pseudocysts are rare cystic masses usually nonfunctional and asymptomatic, discovered incidentally during diagnostic imaging or when complicated by rupture and hemorrhage or infection. Few cases of hemorrhagic adrenal pseudocyst during pregnancy are reported, but a causal relationship between pregnancy and pseudocyst formation has not been shown. We describe a case of a 30-year-old pregnant woman referred to our surgical unit at the 20th week of gestation for incidental detection of left-side upper abdominal cystic mass, with signs of intralesion hemorrhage. The lesion was monitored and the woman gave birth at the 39th week, without complications. After 3 months from delivery, a multislide computed tomography scan confirmed a cystic mass measuring 10×7×10 cm. An elective transperitoneal laparoscopy was performed and a well-capsulated, hemorrhagic adrenal pseudocyst was removed. The optimal surgical treatment for hemorrhagic adrenal pseudocyst during pregnancy is still controversial. The present case shows that adrenal pseudocyst should be carefully monitored and can be treated by elective laparoscopic surgery after delivery.