Introduction: Conventional open parathyroid exploration was the standard of care for treatment of primary hyperparathyroidism until the 1990s, when improvements in imaging techniques made limited (less than 4-gland) exploration feasible (1). Now, many centres worldwide have adopted limited parathyroid exploration as their preferred surgical approach (2-4).The underlying principle behind limited exploration is the fact that approximately 90% of individuals with primary hyperparathyroidism have only one diseased parathyroid gland (5). The challenge is then to find the diseased gland successfully prior to operation. The essential imaging techniques used to localize solitary parathyroid adenomas are parathyroid sestamibi and ultrasound. the sensitivity of each of these techniques approaches90% in experienced hands (6, 7). Therefore, many people with primary hyperparathyroidism can be treated with Minimally Invasive Parathyroidectomy (MIP). Aim of the work: to compare between minimally invasive parathyroidectomy versus conventional open (4-gland) parathyroid exploration for treatment of primary hyperparathyroidism regarding surgical technique,length of operation, duration of hospitalization and recovery. Patients and methods: 12 patients with clinically benign parathyroid tumours were included in this study, ages ranged from38years to 69 years. These patients were managed over a period of 2 years. They were managed Between March 2015 and March 2017 at Ain Shams university hospitals in Egypt. This prospective study included 7males and 5 females. All patients were assessed by clinical examination and investigated by hormonal assay, computerized tomography (C T) and parathyroid sestamibi scan. 6 patients underwent minimally invasive parathyroidectomy(groupA) and 6 patients underwent conventional open (4-gland) parathyroid exploration.(group B). Results: Atotal of 12 patients of which 6 patients underwent a Minimally Invasive Parathyroidectomy while 6 patients had a Conventional open (4-gland) parathyroid exploration. The average age was 47.5 years (range = 38–69 years) with the male to female ratio being 7:5. there was statistically significant increase of intraoperative time in group B (average 85.5 minutes) in comparison to group A(average 65 minutes) but no significant deference as regards intraoperative blood loss. No significant deference was found in relation to hospital stay and there were no postoperative complications in all patients and for 3 months after operation. Conclusion: The success of Minimally Invasive Parathyroidectomy(MIP).has been established by several studies displaying cure and complication rates that are at a minimum in comparison to those achieved by conventional 4-gland exploration. In contrast to bilateral exploration, Minimally Invasive Parathyroidectomy has been shown to be associated with significantly reduced complications.