Abstract: Primary aldosteronism (PA) is a clinical syndrome in which excess production of the hormone aldosterone from the adrenal glands, leads to activation of the renin-angiotensin system, causing a series of pathophysiological changes in the body. PA is divided into unilateral or bilateral adrenal aldosterone secretion, and their treatment methods are essentially different. The former is mostly treated by operation, while the latter is mainly treated with drugs. It's very important to early identify the type of PA in clinical implication. Radionuclide imaging including positron emission tomography (PET) and single photon emission computed tomography (SPECT), which are characterized by molecular probes, functional imaging, and non-invasiveness, are playing an increasingly important role in the classification of PA patients. The author reviews the research progress of radionuclide imaging in PA.