Abstract: Objective: To evaluate the diagnosis and surgical treatment of parathyroid neoplasm.Methods: Data of 42 cases with parathyroid neoplasm undergoing surgical treatment at the Cancer Hospital of Tianjin Medical University between 1980 and 2005 were analyzed retrospectively. Results:Among the cases with parathyroid tumors, 31 were diagnosed with adenoma (73.8%), 6 were diagnosed with carcinoma (14.3%) and 5 were diagnosed with cysts (11.9%). Concomitant hyperparathyroidism was found in 33 of the cases, with major clinical manifestations such as osteodynia and kidney stones. The accuracy rate of preoperative B- US on location and qualitative diagnosis was 92.8% and 61.9% ,respectively, and the accuracy of CT was 91.3% and 65.2%, respectively. All patients were treated with surgery. After a 1 to 26- year postoperative follow up, 40 patients achieved complete remission, 2 suffered relapse and 1 died. Conclusion: Clinicians should heighten their vigilance for parathyroid tumor and they are to be highly suspicious of a possible parathyroid neoplasm when a patient has the following hyperparathyroid symptoms: bone pain, nephrolith and small mass in the inferior part of neck. The routine blood examinations of serum calcium and phosphorus are to be conducted. B- US is the first choice for preoperative diagnosis and CT is another helpful examination method. Surgery is the best approach for patients with parathyroid tumors. Intraoperative exploration of unilateral parathyroid gland for benign parathyroid tumors is advocated, and tumorectomy can be performed on parathyroid adenoma and cysts. In surgical treatment of the parathyroid adenoma, a concurrent resection of homolateral thyroid gland, lobectomy and isthmectomy, as well as removal of peripheral soft tissues is reccommended, however, neck dissection is not necessary for stage cNo cases.