The primary hyperparathyroidism is a pathological condition that needs frequent surgical treatment. Usually it is encountered due to a parathyroid adenoma, but in rare cases it is configured as structured parathyroid tissue in a rich environment with a bulk of adipose cells. This pathology initially described as Hamartoma of the parathyroid gland and then as parathyroid adenolipoma is rarely encountered and it requires special care from medical staff because of the difficulty in its early diagnosis and also its treatment. We are presenting a case treated by our team and a review of the literature on this topic.