【Abstract】 Objective To retrospectively analyze the short-term and long-term outcome of parathyroidectomy (PTX) on patients with refractory secondary hyperparathyroidism (SHPT). Methods A total of 89 cases (49.4±12 years old) with end-stage renal disease and SHPT underwent hemodialysis (average dialysis age 143±50.6 months) and PTX. Their serum iPTH, calcium, phosphorus and alkaline phosphatase in the preoperative, postoperative and follow-up periods were collected and compared. Their symptoms, postoperative complications and relapse were observed and analyzed to determine the efficacy of PTX. Results Thirty cases underwent subtotal PTX, 11 cases underwent PTX + autologous parathyroid transplantation, and 48 cases underwent total PTX. PTX operation performed successfully in 86/89 patients (96.6%), and no cases died in the perioperative period. Temporary injury of recurrent laryngeal nerve was found in 5 cases (5.6%). postoperative hypocalcemia was frequently seen in 65/89 patients (73%), and it was effectively controlled by intravenous calcium. After PTX, bone pain and itching were alleviated, weakness, insomnia and anorexia rapidly improved, and nutritional status also improved. The postoperative iPTH (P<0.001), serum phosphorus (P <0.001) serum calcium (P <0.001) and serum ALP (P <0.001) lowered significantly than those at preoperative period. A long-term follow-up over 3 years was carried out in 27 cases. All of their iPTH increased to more than 100pg/ml. SHPT recurred in 9 cases (33.3%), of whom 7 cases were the patients with subtotal PTX. The longest follow-up period lasted for 5 years. Conclusion PTX is a safe and effective measure for the treatment of patients with end-stage renal disease and refractory SHPT. The postoperative relapse rate of SHPT was slightly higher in patients with subtotal PTX. No severe bone disease was found anymore during the follow-up period in patients with total PTX.