Vorselaars WMCM, et al. - In a first step toward standardization, consensus criteria defining the clinical outcomes after adrenalectomy for primary aldosteronism were introduced by the Primary Aldosteronism Surgical Outcomes investigators. In this retrospective cohort study, the utility of these consensus criteria in daily clinical practice was evaluated in 16 centers in Europe, Canada, Australia, and the United States. Among 380 patients who underwent unilateral adrenalectomy for primary aldosteronism, complete, partial, and absent clinical success was achieved in 30%, 48%, and 22%, respectively, according to the Primary Aldosteronism Surgical Outcomes criteria. Observations revealed substantial advancement in the standardization of postoperative outcomes with the introduction of the Primary Aldosteronism Surgical Outcomes consensus criteria. However, there is room for improvement in the concept for success. Findings suggest that it is still challenging to determine clinical success, particularly in patients with opposing change in blood pressure and defined daily dose.