This bonus summary episode distills the Endocrine Society’s 2025 guideline updates on primary aldosteronism into high yield pearls for clinical practice and board preparation. Key topics include:

• Broad screening for hypertensive patients regardless of potassium status

• Diagnostic evaluation with the aldosterone to renin ratio

• Selective use of suppression testing and updated terminology

• Adrenal vein sampling (AVS) as the gold standard for lateralization

• Surgical vs. medical management based on disease laterality

• Mineralocorticoid receptor antagonist therapy, titration, and renin response

• Cortisol cosecretion testing and its role in surgical planning

• Individualized treatment strategies to improve cardiovascular and metabolic outcomes