Canine hyperadrenocorticism is the third most common canine endocrinopathy in the UK, affecting an estimated 1 in 400 dogs. 85% of dogs with hyperadrenocorticism have a pituitary tumour, resulting in high circulating adrenocorticotropic hormone that stimulates excessive cortisol production by the adrenal gland. The reported treatment of choice for pituitary dependent hyperadrenocorticism is hypophysectomy, but the availability of this technique is limited. Medical treatment with trilostane is the most common treatment. Trilostane treatment aims to reduce cortisol production in the adrenal gland, but it is associated with a 16% rate of adverse effects and requires lifelong treatment and ongoing hormone testing. Bilateral laparoscopic adrenalectomy is presented as a safe and valid, alternative treatment option for pituitary dependent hyperadrenocorticism, with case examples and surgical videos.