In patients with ACTH-independent Cushing's syndrome (primarily including adrenal cortical adenomas and adenocarcinomas) following surgery, glucocorticoid replacement therapy is required due to long-term hypercortisolism-induced suppression of the hypothalamic-pituitary-adrenal (HPA) axis function. This article reviews the three-phase management strategy for this population postoperatively: the acute phase (days 0-14 postoperatively) primarily involves intravenous hydrocortisone, with transition to oral administration based on clinical and biochemical indicators; the tapering phase (2 weeks to 24 months postoperatively) employs a stepwise dose reduction regimen while monitoring symptoms and biochemical parameters; and the long-term follow-up phase (>24 months postoperatively) evaluates HPA axis recovery through ACTH stimulation tests to determine the timing of discontinuation. Additionally, medication adjustments for special populations such as children, pregnant women, and elderly patients are summarized. The aim is to provide practical references for perioperative glucocorticoid management in clinical practice.