A growing number of patients with adrenal incidentalomas and subclinical Cushing’s syndrome (SCS)
led to an increasing number of different guidelines, and diagnostic and treatment recommendations. Excess cortisol
secretion in patients with SCS is associated with several comorbidities, such as hypertension, dyslipidemia,
type 2 diabetes mellitus, and obesity, which in the long-term increase mortality of these patients. Subtle cortisol
secretion affects bone health, quality of life and causes depression, but due to the unapparent clinical features,
patients with SCS are often at risk between over and under treatment. This narrative review aimed to summarize
the latest recommendations on the approach to the patient with subclinical Cushing’s syndrome.