Background: Partial adrenalectomy (PA) is a viable treatment option for patients with adrenal tumours, particularly with pheochromocytomas. PA requires precise intraoperative visualization of the tumour increasing the risk of intraoperative hemodynamic instability, due to direct tumour manipulation. Methods: Between January 2004 and October 2024, 579 patients with pheochromocytoma were operated by the retroperitoneoscopic approach. From 2010, patients were not routinely prepared with alpha-adrenoreceptor blockers. Comprehensive anaesthesia protocols were available for 513 procedures, including 301 partial and 212 total adrenalectomies (TA) and were retrospectively analysed. There was no significant difference between groups regarding preoperative treatment with alpha-adrenoreceptor blockers (36.3% vs. 28.3%, p=0.088). In the PA group there were 144 cases of inherited diseases (85 VHL, 51 MEN II, 8 NF1) compared to 22 (10 VHL, 10 MEN II, 2 NF1) in TA. Results: Patients who underwent TA had larger tumour sizes (4.5±2.1 vs. 2.9±1.2 cm; p<0.001) and a higher prevalence of symptomatic disease (83% vs. 73%; p<0.05). Patients undergoing PA had significantly lower intraoperative maximal systolic blood pressure (180±52 vs. 204±57 mmHg; p<0.05), maximal heart rate (93±24 vs. 100±27; p=ns), and a lower requirement for intraoperative administration of antihypertensive medications (p=0.02). The mean operating time was 53±26 minutes for PA and 63±36 minutes for TA (p<0.05). ICU observation postoperatively was used in 4 patients with PA and in 5 patients following TA (p=ns). Conclusion: Given the potential bias associated with the retrospective nature of the study and differences in the patient population, partial adrenalectomy is not linked to increased hemodynamic risks.