Cushing's syndrome (CS) during pregnancy is a rare condition and challenges in diagnosis and treatment. Uncontrolled CS is associated with maternal complications and adverse fetal outcomes. Adrenal adenoma is the predominantly etiology. Laparoscopic adrenalectomy is the treatment of choice in patient with cortisol-secreting adrenal adenoma especially performing during second trimester. We presented a case of 24-year-old, gravida 1, pregnant woman with history of pregestational diabetes. At 23 weeks of gestation, she developed uncontrolled blood sugar. Biochemical evaluation revealed ACTH-independent hypercortisolism. Adrenal magnetic resonance imaging confirmed the presence of a 2.8 cm left adrenal tumor. We diagnosed her with adrenal Cushing syndrome in second trimester of pregnancy. She underwent a successful laparoscopic left adrenalectomy with intraoperative fetal heart and maternal capnography monitoring. Pathological examination of the gland showed benign adrenocortical adenoma. She recovered uneventfully and discharged on postopertive day 3. Physiological dose of glucocorticoid replacement was given due to transient postoperative adrenal insufficiency which could be gradually reduced and discontinued after 9 months of surgery. She gave birth to a healthy baby (birthweight 2,800 g) at 39-week gestation by normal vaginal delivery. This video demonstrated a standard technique of laparoscopic left adrenalectomy and special considerations for gravid patient. In conclusion, laparoscopic adrenalectomy for patients with cortisol-secreting adrenal adenoma can be performed safely during pregnancy with intensive intraoperative monitoring that provided good surgical outcomes and preventing complications secondary to hypercortisolism.