A case of adrenocortical carcinoma, in a 24-yr-old woman who has to date survived 8 years, is presented. A number of findings have been discussed, such as the local recurrence of the tumor during a third pregnancy, the demonstration of a partial placental barrier to cortisol, the birth of a normal child with well-functioning adrenals in the presence of high levels of maternal cortisol, and the management of pregnancy in the presence of functioning adrenocortical carcinoma.