Intraoperative PTH monitoring is a commonly utilized tool in the surgical management of patients with primary hyperparathyroidism. Its use during parathyroidectomy guides the surgeon in operative decision-making and is an often critical aspect of the surgery itself. Intraoperative PTH monitoring has several benefits over traditional bilateral neck exploration, including reduced operative times, hospital stays, and potential complications. Most surgeons recommend using a >50% PTH drop criterion from the pre-incision PTH value to a 10 min post-excision PTH value for measuring operative success. Additionally, many surgeons recommend a post-excision PTH value that returns to the normal reference range. This criterion has improved accuracy in identifying parathyroid adenomas with reduced unnecessary bilateral neck exploration. Further investigation is required into the utility and efficacy of intraoperative PTH monitoring for parathyroid disorders other than primary hyperparathyroidism.