The association of primary adrenal insufficiency with antiphospholipid antibodies is usually reported in the context of adrenal thrombosis or hemorrhage. We describe a 35-year-old woman who developed a primary antiphospholipid syndrome (spontaneous abortion, thrombocytopenia, and cerebrovascular occlusion) in association with primary adrenal insufficiency without evidence of suprarenal hemorrhage or thrombosis.