Abstract: Hyperparathyroidism is a metabolism disorder of calcium and phosphorus caused by excessive parathyroid hormone. Surgery is a conventional and most effective treatment method. Accurate preoperative localization and characterization are very critical for successful parathyroidectomy. Most studies have shown that radionuclide imaging plays an important role in preoperative parathyroid localization diagnosis. In particular, new imaging agents (such as ¹⁸F-fluoromethyl choline) have good development prospects. This article summarizes the research progress of parathyroid SPECT and PET imaging and different radioactive imaging tracers in the diagnosis of hyperparathyroidism.