Six out of a series of 10 patients with hyperparathyroidism associated with an MEA type I syndrome were treated by subtotal parathyroidectomy with resulting normocalcaemia over a follow-up time of one to 7 years. Three patients with repeated previously unsuccessful operations underwent total parathyroidectomy with simultaneous autotransplantation. The first type of operation remains our first choice, while the radical approach with forearm transplantation is reserved only for recurrent surgery for various reasons.