The management of primary hiperparathyroidism is surgical and it is succesfully managed by experienced surgeons. Imaging methods are useful to localize parathyroid gland patologies. The role of surgery and peroperative approach are still controversial in patients with asymptomatic hiperparathyroidism. In this study, 20 patients undergone to 21 neck exploration for primary hiperparathyroidism in our clinic between 1996 and 2001 were reviewed, retrospectively. Preoperative diagnostic methods, symptoms, localization studies, preoperative approach, supplementary patologies and postoperative complications evaluated. The common symptoms are weakness and joint pain. Neck ultrasonography (USG) was the mostly used imaging method, and that has 74 % success for localizing parathyroid lesions. In the symptomatic cases, P values were decreased and PTH, Ca⁺⁺, ALP were high and they were significantly decreased at postoperative period. Of 21 neck explorations, 11 (52%) were bilateral and 10 (48%) were unilateral. One patient underwent to reoperation for recurrent hiperparathyroidism. Four patients were asymptomatic and they were operated without complication. Most often found supplemantary pathology in patients was MNG. Neck USG was an noninvasive, inexpensive and successful method. After successful localization, If there was no supplementary pathology of thyroid, unilateral neck exploration would be sufficient for primary hiperparathyroidism.