Abstract: Primary aldosteronism (PA), the most prevalent cause of secondary hypertension, is characterized by excessive aldosterone secretion. This condition not only leads to hypertension and hypokalemia but also inflicts severe target organ damage upon the cardiovascular, renal, and metabolic systems, independent of blood pressure levels. With the advancement of clinical research, the therapeutic landscape for PA has evolved from a traditional binary choice between surgical resection and pharmacological antagonism toward more diversified, refined, and minimally invasive modalities. This article systematically reviews the relevant literature to summarize the current research status and future prospects of treatment strategies for PA.