Basic patient profile: Xu X, female, 38 years old (at the time of ablation). 2 years ago, primary hyperparathyroidism was diagnosed during a detailed examination for multiple renal stones, the lesion was located in the left lower parietal gland, with a size of about 26mm*8mm*7mm and a very rich blood supply to the nodule. Preoperative PTH: 141.4 (upper limit of normal is 88). Treatment procedure: After admission, the patient underwent the necessary preoperative tests, including three major routine tests, thyroid and parathyroid functions, blood electrolytes, coagulation function, and electrocardiogram, and then underwent ultrasound-guided microwave ablation therapy. The total treatment time was 40 minutes, of which the ablation time was only 1 minute and 32 seconds, and the rest of the time was spent on preoperative preparation and postoperative observation. The PTH decreased to the normal range of 25.4 at 10 minutes postoperatively. 20 minutes postoperatively, PTH: 18.6. 24 hours postoperatively, PTH: 6.1. The change in PTH showed that the parathyroid nodule had been completely ablated in this patient. Post-ablation performance The left inferior parathyroid gland was significantly smaller as seen the day after ablation Summary: Primary hyperparathyroidism is a rare disease with no obvious manifestations at the beginning but serious consequences. Many patients are seen for pathological fractures (i.e., fractures of large bones occurring with minor exertion) or for renal failure due to multiple kidney stones. However, by this stage, the complications of hyperparathyroidism have led to severe multiple dysfunction in patients, and therefore routine screening for parathyroid function is advocated for patients with multiple kidney stones. The traditional treatment is surgical excision, but the excision inevitably results in the formation of a neck scar. Local injections of anhydrous ethanol have been tried but have been abandoned due to poor and unstable efficacy. Microwave ablation has now become an important tool in the treatment of primary hyperparathyroidism. We have had five patients treated satisfactorily, with PTH falling to within the normal range 10 minutes after the procedure. Therefore, microwave ablation may be considered first for patients with primary hyperparathyroidism.