This retrospective study sought to report our institutional experience in stereotactic ablative radiotherapy (SABR) for adrenal gland metastases in lung cancer and the impact of histology subtype and molecular profile on clinical outcomes. Materials/Methods: Data were retrieved from lung cancer patients with controlled disease under systemic therapy received SABR to adrenal gland metastases between 2012 to 2018 in a single medical center. Tumor response was evaluated by revised Response Evaluation Criteria in Solid Tumors guideline using computed tomography scans. Local failure was designated as recurrence within the irradiated field. Progressive disease or new lesions outside the treated adrenal tumor(s) was defined as distant failure. Overall survival (OS), progression-free survival (PFS), time to local failure (tLF) and time to distant failure (tDF) were estimated using Kaplan-Meier method from the date of SABR delivery. Cox proportional hazards method was used for evaluation of prognostic factors. Results: In total, 29 patients were enrolled for analysis, and 23 had oligometastatic disease. SABR was delivered with a median dose of 50 Gy (range 36-50 Gy) in 4-6 fractions (median, 6 fractions). Twenty-three patients had non-small cell lung cancer (adenocarcinoma 18, squamous cell carcinoma 3), and 6 had small cell lung cancer. The median planning target volume (PTV) was 79 cc, and the median biological equivalence dose (BED) was 66.7 Gy (range 57.6-105.6 Gy). There were 3 complete response (CR, 9%), 19 partial response (PR, 59%), 7 stable disease (SD, 23%), and 3 progressive disease (9%). The overall objective radiographic response (ORR, CR+PR) rate and disease control (CR+PR+SD) rate were 78% and 91%, respectively. With a median follow-up of 9.5 months, the median OS, PFS, and tDF were 9.5 months, 4.2 months, and 4.3 months, respectively. The median tLF was not reached. In univariate analysis, ORR was associated with an improved OS (pZ0.04), PFS (pZ0.008), tLF (pZ0.006), and tDF (pZ0.02), while oligo-metastatic status was a favorable prognosticator of OS (pZ0.046), PFS (pZ0.008) and tDF (pZ0.003). Lung cancer histology was not associated with ORR, OS, PFS, tLF, or tDF. The significance of both ORR and oligo-metastatic status remained in multivariate analyses. In the subgroup of NSCLC adenocarcinoma, 45% had mutant epidermal growth factor receptor (EGFR). There were no significant differences in ORR or survival outcomes between patients with wild type EGFR and those with mutant EGFR. No patients experienced grade 3 to 5 toxicities. Conclusion: SABR to adrenal metastases is well-tolerated and provides excellent local control in lung cancer patients. Histology subtype or EGFR mutation status has no impact on clinical outcomes. Patients with radiographic response or oligometastatic disease had favorable survivals.