Primary hyperparathyroidism, a disorder in wich there is a hypercalcemia caused by autonomous hypersecretion of parathormone, usually by parathyroid adenoma. It is asymptomatic in most cases. After excluding a cause of secondary elevation of parathyroid hormone, a search for renal stones and osteoporosis has to be done. The treatment of choice is parathyroidectomy and it is recommended in case of complications, hypercalcemia with calcium up to 0.25 mmol/l higher than the upper limit and in patients <50 years. Specific pharmacological approaches (bisphosphonate or cinacalcet) may be of value if the patient meet surgical guidelines but is not a candidate for parathyroid surgery. Patient who do not meet surgical indications should be monitored.