Background: The coexistence of primary hyperparathyroidism (PHPT) and thyroid disease (TD) is a well-known entity. The aim of our study is to report our experience, to evaluate the prevalence of this association with review of the literature. Methods: We retrospectively examined the operative database over the past 03 years. We looked for patients who underwent parathyroid surgery. All patients underwent preoperative neck US and Tc99m sestamibi scintigraphy and /or CT scan or MRI. Results: Among the 43 patients who underwent a parathyroidectomy. Preoperative thyroid US revealed that 62, 79 % of patients with PHPT had thyroid abnormalities. 58, 14 % patients underwent parathyroidectomy, whereas 41, 86 % patients underwent both parathyroidectomy and thyroidectomy. Postoperative histopathology results showed that 62.96% of patients had benign thyroid disease and 3.70 % of patients had malignant thyroid disease. Conclusion: In our study, we found a high prevalence of concomitant thyroid disease and PHP T. however, one patient had a micro papillary carcinoma and that emphasize the importance of careful judgment to avoid over-treatment