Objective To analyze the clinical characteristics, diagnosis and treatment of ACTH-independent Cushing's syndrome caused by bilateral adrenal high functional cortical adenomas, and improve the cognition of the disease. Methods This paper reports the general situation, symptoms and signs, auxiliary examination, diagnosis and treatment of 3 patients with ACTH-independent Cushing's syndrome caused by bilateral adrenal functional cortical adenomas in Adrenal Center, the Department of Endocrinology and Metabolism, West China Hospital. Results All 3 patients showed typical and severe Cushing's syndrome, and severe cardiac and metabolic complications. CT scan imaging showed bilateral adrenal solitary nodules. Two patients underwent bilateral adrenal veins sampling, which indicated that both high secretion of bilateral adrenal gland. One patient underwent simultaneous bilateral adrenalectomy, and the other 2 patients underwent bilateral adrenalectomy by stages because of serious cardiac insufficiency. Postoperative pathology showed bilateral adrenocortical adenoma in 3 cases, and the cortisol concentration decreased significantly after operation. All patients were given long term glucocorticoid replacement therapy after operation. Conclusion ACTH-independent Cushing's syndrome caused by bilateral adrenal functional cortical adenoma is very rare, so it is very important to make a clear diagnosis and judge the bilateral functional orientation. In treatment, the most suitable surgical method should be selected individually according to the patient's condition and complications. After operation, close followup should be made, glucocorticoid replacement therapy should be administrated and adjusted in time, and lifelong follow-up.