Background. Patients with end-stage renal disease (ESRD) have a decreased quality of life (QoL), which is attributable in part to secondary hyperparathyroidism (2HPT). Surgery is the definitive treatment of 2HPT. The aim of this study is to assess the effect of total parathyroidectomy with deltoid autotransplantation on the QoL. Methods: A total of 201 ESRD with 2HPT were enrolled . The operation efficacy was evaluated by analyzing preoperative and postoperative values, including levels of intact parathyroid hormone (iPTH), serum phosphorus, serum calcium, alkaline phosphatase (ALP) and calcium-phosphorus product. The QoL was evaluated by MOS 36-item short-form health survey (SF-36) scores preoperatively and at 6 months postoperation. Results: Compared with the preoperative values, levels of PTH(2033pg/ml vs 62.5 pg/ml), serum phosphorus(2.30mg/dl vs 1.60mg/dl), serum calcium(3.62mg/dl vs 1.84mg/dl), and calcium-phosphorus product were all decreased postoperative. Number variation and anatomic location variation of thyroid glands were found in the patients. Quality of life improved significantly in all 8 individual and 2 component summary scales, with a more significant decrease in the physical health scales. Conclusion: Parathyroidectomy significantly improves quality of life in patients with secondary hyperparathyroidism.