ackground: PHPT can be symptomatic or asymptomatic, according to the presence of classic symptoms (skeletal or renal involvement), without conclusive evidence of its relation to biochemical parameters. Objective: The objective of the study was to characterize clinical and biochemical profiles in symptomatic and asymptomatic PHPT. Methods: A cross-sectional study in patients with parathyroidectomy at a private hospital. Clinical and biochemical reports of 61 cases were collected from 2010 to 2018. Results: Median age was 59 ± 13 years and 72% were women. Of the total sample, 42 were symptomatic and 19 asymptomatic (68.8% vs. 32.2%). Neurocognitive and cardiovascular syndromes had a higher proportion in symptomatic cases (p = 0.02 and p = 0.01, respectively). Conclusions: Serum calcium and PTH levels are not related to target organ injury in the pre-operative setting, but statistically higher postoperative serum calcium levels were found in the symptomatic group. Further research is needed to elucidate the relation of biochemical parameters and symptoms in PHPT progression.