Abstract: This paper reported a case of sporadic parathyroid carcinoma with negative ⁹⁹Tc^m-methoxyisobutylisonitrile (MIBI) imaging. The patient with parathyroid carcinoma is characterized by severe hypercalcemia which could cause pathological changes in multiple systems and different organs. It depends on ultrasound, parathyroid nuclide scan (⁹⁹Tc^m-MIBI) and CT examination to localize the position of lesions for further operation treatment. Among these examinations, parathyroid ⁹⁹Tc^m-MIBI imaging is widely used in clinical for its easy accessibility and high sensitivity. However, there are some cases presented with negative ⁹⁹Tc^m-MIBI imaging and is easy to be misdiagnosed. Through the literature review, the author deeply understood the negative ⁹⁹Tc^m-MIBI imaging of parathyroid carcinoma. For patients suspected of parathyroid carcinoma but with negative ⁹⁹Tc^m-MIBI imaging, the possibility of false negative need to be considered. In this specific clinical scenario, doctors should analyze its potential causes and make a comprehensive judgment through combining with other clinical characteristics, which could reduce the rate of misdiagnosis as much as possible.