OBJECTIVE: Primary hyperparathyroidism (PHPT) is a frequently encountered endocrine disease in the elderly, but little is known about ist epidemiology in the aging European population. This study investigates the age- and sex-dependence of PHPT and the incidence of parathyroidectomy (PTX) in Switzerland, a country with a particularly high life expectancy. DESIGN: A population-based study was performed using data from the Swiss Federal Statistical Office covering years 2000 to 2004. Anonymised hospital discharge codes for PHPT and PTX were analysed, and the hospitalisation rate for PHPT and incidence of PTX were calculated. RESULTS: The mean annual hospitalisation rate of patients with PHPT was 8.3/100,000 inhabitants. The rate was approximately three times higher in women than in men, with the highest estimate found in women ≥ 80 years (63.7/ 100,000). The population-adjusted annual incidence of PTX was 3.8/100,000 inhabitants. PTX incidence was higher in individuals ≥ 50 years than in younger persons (8.7/100,000 vs 1.3/100,000), with a peak in patients aged 70-74 years. CONCLUSIONS: In a European population with high life expectancy, the hospitalisation rate of PHPT is higher in women and increases continuously with age. Incidence of PTX is highest in patients aged 70-74 years. These findings underscore the need for further research on the impact of population aging on the treatment patterns of PHPT.