Abstract: Primary hyperparathyroidism (PHPT) is a common endocrine disease, which is usually caused by hyperparathyroidism. Surgical resection of hyperfunctional lesions is the main treatment for PHPT, and correct location of the lesions is very important to guide the minimally invasive surgical treatment of PHPT patients. PET/CT has been used as the first-line imaging method for preoperative localization of parathyroid adenoma, and how to screen the patients suitable for PET/CT from the serum biochemistry has become the focus of clinical application, as well as the analysis of its relationship with PET related parameters from the level of pathology and immunohistochemistry is the focus of current research. This article mainly analyzes the relationship between biochemical level, pathological information, immunohistochemical analysis and PET/CT related parameters of PHPT, providing guidance for the clinical application of PET, and further introducing the new imaging progress of preoperative localization of PHPT.