Primary hyperparathyroidism (HPT) is a common disease that occurs in one of 500 women and one of 2,000 men over the age of 40. In 85% to 90% of patients, primary HPT is caused by a solitary parathyroid adenoma. Recent advances in evaluation and surgical management of HPT, including improved localization techniques and intraoperative parathyroid hormone (PTH) monitoring, have permitted a more targeted approach to parathyroid surgery.