Abstract: ⁹⁹Tc^m-MIBI SPECT exhibited high sensitivity in hyperparathyroidism. Combination of ultrasound or CT can raise the diagnostic and location accuracy, especially in ectopic parathyroid adenoma. With the development of minimally invasive parathyroidectomy, the value of ⁹⁹Tc^m-MIBI SPECT/CT in preoperative location accuracy stands out. Many factors such as size of the gland lesions and biochemical indexes affect the sensitivity and location accuracy of ⁹⁹Tc^m-MIBI scintigraphy. For the negative imaging hyperparathyroidism patients, ¹¹C-methionine PET/CT, 4D-CT and intraoperative radiation navigation is current research hot spot and development orientation.