Minimally invasive radioguided parathyroidectomy (MIRP) is considered by some as the preferred treatment for primary hyperparathyroidism. Traditionally, surgical approach to parathyroidectomy consisted of bilateral central neck exploration with removal of the identified enlarged adenoma and at least one normal gland. Technological advances in preoperative imaging and intraoperative localization techniques have allowed for reliable identification of the often single hypercellular gland without the need for bilateral neck exploration. As compared to bilateral neck exploration, MIRP is associated with shorter operative times, cost savings, and decreased patient morbidity. In cases where MIRP is feasible, the cure rate of primary hyperparathyroidism is comparable to the historical gold standard of bilateral neck exploration with parathyroidectomy.