A review of the organization and practice of parathyroid surgery in Scandinavia indicated that it was undertaken in about half of the surgical clinics. About half of these clinics treated only primary hyperparathyroidism (HPT), and in the great majority all parathyroid operations were done by one or two surgeons. The results of surgical treatment were compared in two large Scandinavian series of primary HPT, one based on a general survey of parathyroid surgery in 1975, and the other on results obtained during 1971-1980 in centres specializing in endocrine surgery (Bergen, Stockholm, Uppsala). In the latter series 90% of the patients were normocalcaemic at follow-up averaging 4.4 years after parathyroid surgery whereas in the general survey the rate of normocalcaemia was 76%. At hospitals performing less than ten parathyroid operations per year it was only 70% and there was high incidence of persistent HPT (15%) and presumed permanent hypoparathyroidism (14%). The findings strongly advocate special training and interest in parathyroid surgery in order to ensure success.