Background: Adrenal crisis is a life‑threatening medical emergency associated with high mortality unless it is recognized early and treated. Aims: The aim of this study was to evaluate the clinical characteristics, etiology, and outcomes of patients with adrenal crisis. Methods: This was a hospital‑based, prospective study of 35 adult patients, age >18 years diagnosed with the adrenal crisis. Patients were studied for clinical, etiological, laboratory parameters, comorbidities, and outcome. Results: The mean age of patients with the adrenal crisis was 47.2 ± 16.8 years, and there was female (68.6%) preponderance. The most common mode of presentation was hypotension (100%), shock (94.3%), altered sensorium (28.6%), hyponatremia (45.7%), hypoglycemia (17.1%), and sepsis (37.1%). Hypoglycemia and hyperlactatemia were predominantly found in patients without known adrenal insufficiency before the presentation. Secondary adrenal failure (57.1%) followed by sepsis‑related adrenal failure (34.3%) and primary adrenal failure (8.1%) was the most common cause of admission. Secondary adrenal failure comprised of withdrawal of exogenous glucocorticoid therapy (25%), Sheehan syndrome (30%), pituitary surgery (15%), and pituitary tumor (15%). Overall mortality was 17.1%, with the highest mortality for sepsis‑related adrenal failure (33.3%). Elderly (age >60 years), altered sensorium, serum sodium <120 mEq/L, hypoglycemia, multiorgan dysfunction syndrome (MODS), and lactic acidosis significantly increase the mortality in adrenal crisis. Conclusions: Patients with adrenal crisis carry significant morbidity and mortality with particular emphasis on sepsis‑related adrenal failure. The factors predicting mortality in adrenal crisis are elderly, altered sensorium at presentation, severe hyponatremia, hypoglycemia, MODS, and lactic acidosis.