Objective: To assess the clinical value of intraoperative parathyroid hormone (IOPTH) monitoring for patients with primary hyperparathyroidism (PHPT) during parathyroidectomy. Methods: The clinical data of 36 PHPT patients undergoing surgical treatment from January 1998 to January 2012 were retrospectively analyzed. Of the patients, 22 cases (before 2005) received IOPTH monitoring (IOPTH group) during surgery and 14 cases (after 2005) underwent parathyroidectomy without IOPTH monitoring (conventional group). The intraoperative conditions and therapeutic efficacies between the two groups were compared. Results: Compared with conventional group, in IOPTH group, the operative time was reduced [(72.95±24.34) min vs. (81.86±29.46) min, P=0.000], ratio of patients with short-term (within the first month after surgery) recovery of parathyroid function increased (90.9% vs. 57.1%, P=0.018), and incidence of permanent hypoparathyroidism decreased (4.5% vs. 28.6%, P=0.042). The sensitivity and accuracy of IOPTH monitoring for judgment of whether or not the hyperfunctioning lesions were completely resected was 100% and 95.5%, respectively. Conclusion: On the basis of preoperative localization, using IOPTH monitoring during parathyroidectomy is helpful to determine whether the hyperfunctioning glands are completely removed, and to avoid missing a synchronous lesion and unnecessary bilateral exploration. In addition, it reduces the operation time and is of precise efficacy.