Although genetic alterations involving ARMC5 have been implicated in its development, individual nodules within the same adrenal gland often show considerable variability in size, morphology, and hormonal activity, and detailed genetic evaluation of each nodule has rarely been performed. We report the case of a 58-year-old man with a long-standing history of hypertension who was found to have bilateral adrenal nodules on imaging studies. The gene discussed is ARMC5; the disease is Hypertension.