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Minimally invasive parathyroidectomy (MIP) is the standard treatment for primary hyperparathyroidism (pHPT). 1 The intraoperative identification of the lesions is one of the main difficulties that the surgeon may encounter during MIP. To ease the surgical localisation of pathological parathyroid tissue and reduce surgical manipulation, we have introduced in our clinical practice a bidimensional visual map based on preoperative ultrasonography that can be used during surgery. The study aimed to evaluate the success and complication rates of MIP using intraoperative parathyroid hormone testing (IOPTH) and an ultrasound-based visual map (US-VM) at our tertiary referral centre. | DE S I G NRetrospective analysis of the clinical records of consecutive patients surgically treated for pHPT between 2012 and 2019. The STROCSS guidelines (2019) 2 were followed.