The arterial hypertension (HTA) of endocrine origin, account for over half of secondary hypertension causes. This etiological entity comprises several distinct disorders, the most common being primary aldosteronism (PAHs). Its symptoms are very unspecific, but the association of hypertension with hypokalemia, should guide the investigations to confirm PAH. We report the case of a woman of 40 years old, who has a resistant hypertension to triple therapy, the systolic blood pressure is 170 mmHg and diastolic blood pressure is 120 mmHg, with hypokalemia 1.9 mEq /L, and a high urinary potassium at 87 mEq /24h. The report Aldosterone / Renin was very high. The scan showed an adrenal mass of 23.3 mm, without abnormality of the renal arteries. A treatment based on Spironolactone has been established, and adrenalectomy thereafter. The evolution was marked by normalization of blood pressure, of serum potassium, and the rate of aldosterone. Primary aldosteronism by Conn adenoma, now covers 10% of hypertensive patients, and should be suspected when hypokalemia is present in untreated hypertensive, or resistant to antihypertensive drugs. The diagnostics have refined: they are now more sensitive, specific and indications are more accurate, allowing better management of patients.