Secondary hyperparathyroidism (SHPT) represents a prevalent and severe complication in patients with chronic kidney disease, particularly in patients with end‑stage renal disease. The parathyroid hormone type 1 receptor (PTH1R), as a core target regulating calcium‑phosphorus metabolism, has become a hotspot in the development of novel therapeutics. Compared with traditional peptide‑based drugs, antibody‑based agents offer advantages such as high affinity, high specificity, and potential for engineering modifications. Antagonistic PTH1R antibodies can effectively block the parathyroid hormone/parathyroid hormone‑related peptide signaling pathway and have demonstrated efficacy in SHPT animal models by reducing serum parathyroid hormone and phosphorus levels, as well as alleviating parathyroid hyperplasia. Based on recent domestic and international literature, this review systematically analyzes the biological functions of PTH1R, its mechanisms in SHPT, and the technical advantages of antibody (particularly nanobody) screening approaches such as phage display technology. The aim is to summarize the functional properties of therapeutic antibodies targeting PTH1R and their potential application value in SHPT treatment. Future research should focus on antibody humanization, long‑acting design, and validation in animal models to facilitate clinical translation.