Objective: To investigate the diagnosis, preoperative localization, surgical treatment and prognosis of parathyroid tumors. Methods: The clinical data of 45 patients with parathyroid tumors admitted between 2001 to 2012 were retrospectively analyzed. Results: All the parathyroid tumors of the patients were correctly located by B-type ultrasound, and/or CT scan and 99mTc-MIBI, with a sensitivity of 86.7%, 93.8% and 100%, respectively. The 45 patients underwent surgical treatment, and all their lesions were solitary, among which there were 7 left superior, 23 left inferior, 4 right superior, and 11 right inferior parathyroid glands. The postoperative pathology identified that the lesions were parathyroid adenoma (39 cases), adenocarcinoma (1 case) and cyst (5 cases), respectively. The cysts were non-functional, while the adenomas and adenocarcinoma were all associated with primary hyperparathyroidism (PHPT). Before surgery, there were varying degrees of serum calcium level increase and serum phosphate level decrease in all of the PHPT patients, 24 cases of whom had a high parathyroid hormone (PTH) level. The serum calcium levels were decreased and serum phosphate levels were increased significantly in these patients after surgery (both P<0.05), and both levels returned to normal within 1 week to 3 months. The high PTH levels were also significantly decreased after surgery (P<0.05), which became normal within 1 to 5 d in 22 cases, and after 1 year in 2 cases. The intraoperative PTH (IOPTH) monitoring indicated that the successful resection rate for adenoma was 100%. Follow-up was obtained in 40 patients for 3 months to 10 years, during which no recurrence or missed lesion was noted. Conclusion: Parathyroid tumors have a slow onset with diverse clinical manifestations. Serum calcium, phosphorus and PTH levels detection are helpful to diagnose PHPT. Ultrasonic examination can be used as the first option for preoperative localization of parathyroid tumors and the localization rate can be enhanced by combination of CT and 99mTc-MIBI. Surgical resection is effective and the first choice for treatment of parathyroid tumors.