Diseases of the parathyroid gland are rare and are especially in case of hyperparathyroidism associated with hyperacalcaemia. Enlarged glands are, therefore, generally not detected with imaging modalities. The aim of imaging studies is to locialize abnormal glands. Ultrasound is the modality of choice for the primary investigation followed by nuclear medicine studies. Computed tomography or angiography with vein sampling should only be performed if the results of other investigations are equivocal. Magnetic resonance imaging is performed rarely in Austria with its high prevalence of endemic goiter.