Abstract: Objective To investigate the interference of inferior right hepatic vein（IRHV） in right adrenal vein sampling（AVS） and the avoidance methods. Methods Data of 110 patients undergoing AVS at the Second Affiliated Hospital of Zhejiang University School of Medicine from June 2018 to January 2021 were collected. The differences of right AVS in the groups with or without IRHV were analyzed. Right AVS failure, intubation time ＞30 min, repeated detachment of catheter during blood collection, misidentification of blood vessel, and the need to blood collection again according to the fast intraprocedural cortisol testing were defined as right AVS difficulty.Results A total of 62 patients（56.4%） were identified with IRHV. The rates of right AVS difficulty in the group with IRHV and without IRHV were 17.7%（11/62） and 2.1%（1/48） respectively with a significant statistical difference（P=0.021）. In groups with IRHV and without IRHV, the right AVS success rates were 96.8%（60/62）, 97.9%（47/48）, the time of successful intubation were（9.54±1.55）,（7.57±1.96） min, and the complication rates were 8.1%（5/62）, 4.2%（2/48）, respectively, the differences were not statistically significant（all P＞0.05）. The interference of IRHV were:（1）it might be mistaken for right adrenal vein（RAV）, and the way to avoid it was to be familiar with image of IRHV;（2）it might be close to or shared drainage with RAV, leading to difficulty in intubation, and the way to avoid it was to be familiar with the anatomical relationship between IRHV and RAV;（3）it might cause instability of blood collection or blood dilution, and the way to avoid it was the application of coaxial guide wire-catheter technique. Conclusions IRHV interferes with the identification, intubation and blood collection of right AVS, but has no significant effect on outcome for experienced operators who have mastered the avoidance methods.