<p>Primary hyperparathyroidism (PHPT) is associated with metabolic disorders like impaired glucose metabolism, diabetes mellitus, dyslipidaemia, hypertension, obesity, which are the potential cardiovascular risk factors. There are conflicting results about the improvement of these after parathyroidectomy (PTx). This study aims to evaluate the effect of PTx on cardiovascular risk factors in patients of PHPT. Prospectively 26 PHPT patients who underwent PTx were included and patients with history of angina / revascularisation / valve surgery or who were taking anti-lipidemic drugs were excluded from the study. Baseline lipid profile, HbA1c, fasting blood sugar, serum Insulin, HOMA-IR and 2D-ECHO were assessed preoperatively and at 6 months postoperatively. The Framingham General Cardiovascular Risk Score (CRS) was used to estimate the 10-year risk of coronary artery disease. Metabolic syndrome was present in 8 patients and improved in 6 after PTx (<i>P</i> = 0.014). The Framingham CRS decreased from 5.35 ± 7.53 to 4.02 ± 5.87 (<i>P</i> = 0.001), reducing 10-year coronary artery disease risk from 2% to 1%. Echocardiography also showed improvement in systolic and diastolic dysfunction, with significant improvement in left ventricle ejection fraction (<i>P</i> = 0.022) and E/A ratio (<i>P</i> = 0.034). However, there was increased predisposition for type-2 DM with increased serum insulin (<i>n</i> = 4) and HOMA-IR (<i>n</i> = 14) preoperatively which persisted postoperatively. There was significant improvement in cardiovascular risk factors, diastolic dysfunction and Framingham Cardiac Risk Score in PHPT patients after PTx. Hence, we suggest that PTx should be considered as a treatment option in patients of PHPT who have cardiovascular risk factors to avoid development of end organ damage.</p>