Abstract
Neonatal adrenal hemorrhage is an uncommon finding that may resemble suprarenal tumors. We describe a term male neonate who developed Escherichia coli urosepsis and was incidentally found to have a left suprarenal cystic lesion. Imaging and laboratory workup excluded malignancy, and the infant remained stable under conservative treatment with antibiotics and serial ultrasound follow-up. This case emphasizes the need to consider adrenal hemorrhage in septic neonates with abdominal masses and supports noninvasive management in the absence of malignant features.