An asymptomatic adrenal mass was discovered in an elderly patient during evaluation of an abnormal urinary sediment. Exploratory laparotomy revealed an adrenal hematoma as the cause of the mass. No clear cause of the adrenal hemorrhage was identified, and postoperatively there was no evidence of adrenal insufficiency. Though rare, signs of adrenal hemorrhage may include an asymptomatic adrenal mass, and should be considered in the differential diagnosis of this problem.