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Primary hyperparathyroidism is a relatively common endocrine disorder that can lead to hypercalcemia and, consequently, cause long-term renal and skeletal complications. Usually, the diagnosis of this disorder is made at an asymptomatic stage. We report three cases of primary hyperparathyroidism revealed by acute pancreatitis, which is an unusual initial manifestation. The three patients, aged 55, 61, and 78 years, experienced acute epigastric pain accompanied by vomiting. Laboratory tests showed hyperlipasemia, and the abdominal CT scan revealed acute necrotizing pancreatitis. After an investigation into the underlying causes, the diagnosis of primary hyperparathyroidism was confirmed, and imaging identified the presence of parathyroid adenoma in all three patients. Parathyroidectomy was performed and the anatomopathological examination confirmed the diagnosis of parathyroid adenoma.

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