Abstract: Objective To investigate the effects of percutaneous superselective adrenal artery embolization（SAAE） on the clinical and biochemical prognosis in primary aldosteronism（PA） based on the results of adrenal vein sampling（AVS）. Methods PA patients, diagnosed by screening test and confirmatory test, were included consecutively during January to December in 2021. Base on the results of adrenal CT and AVS, those patients were divided into 2 groups: aldosteronoma group（aldosterone-producing adenomam, APA, n=26） and adrenocorticohyperplasia group（non-APA, n=12）. The dominant secretory side was determined by AVS and then underwent SAAE surgery. Baseline characteristics, as well as blood pressure, use of antihypertensive drugs, plasma aldosterone, plasma renin and serum potassium at 1 and 6 months follow-up after SAAE, were compared according to the internationally unified primary aldosteronism surgical outcome（PASO） criteria. Binary logistic regression analysis was used to analyse the predict factors for postoperative biochemical success afetr SAAE. Results Compared with baseline, systolic and diastolic blood pressure were decreased significantly, the kinds of antihypertensive drugs were decreased, and serum potassium were increased in each group at 1 and 6 months follow-up after SAAE. Reduced serum aldosterone, increased renin concentrations and reduced aldosterone to renin ratio（ARR） were observed in APA（all P＜0.05）. Compared with non-APA, APA patients attained higher rate of complete biochemical success at 1 and 6 months after SAAE, while there was no significant difference in surgical complications between the two groups. Binary logistic regression analysis revealed that adenoma, diagnosed by adrenal CT, was a predictor of complete and partial biochemical success at 6 months after SAAE. Conclusions SAAE treatment can lower the blood pressure of PA patients and significantly reduce the elevated ARR value. The biochemical outcomes of SAAE treatment is better when the PA diagnostic type was aldosteronoma.