Primary hyperparathyroidism is a systemic disease, more and more frequently recognized-concerning 1 to 3% of the population. Statistically appears in 1 of 1000 adults, with significant advantage of women. In Poland every year about 30 new cases are noticed and incidence increases with an age. In spite of significant advance of the knowledge, it still makes a lot of diagnostic troubles. It appears to be non-specific illness, characterised by just one symptom, mainly urolithiasis, sometimes chronic ulcer disease, chronic pancreatitis, arterial hypertension, disorders of the movement or psychic disorders. Parathyroid adenoma which is the main reason of the disease is usually single and small, multiple and bigger ones are found exceptionally. In about 2% of cases they are localized in mediastinum. In the article the basic symptoms, diagnostic and therapeutic problems were shown, especially concerning surgical treatment which is safe, radical and efficacious method when performed by experienced surgical team and the conduct from choice on primary and secondary hyperparathyroidism.