While the parathyroid glands were likely recognized as early as 1850 by English anatomist Sir Richard Owen in an Indian rhinoceros (1), the first detailed description of these glands is generally attributed to Ivar Sandstro¨m in 1880 (2). He dubbed these structures glandulae parathyreoideae, though their function was unknown until Gley demonstrated that removal of these glands with experimental thyroidectomy in dogs resulted in tetany, while preservation did not (3,4). The subsequent discovery in the 1900s that parathyroid extract was able to reverse postthyroidectomy tetany ultimately led to the characterization of parathyroid hormone (PTH) (5). Ever since the first parathyroidectomy for tumor was performed by Mandl in 1924 (4), management of parathyroid disease has required close communication between the pathologist and surgeon. Over the next several decades, the introduction of advances such as rapid intraoperative PTH measurement and Sestamibi nuclear scanning have only served to reinforce the multimodal approach to management of parathyroid disease (5). Today, the pathologist needs to be aware of the uses and limitations of clinical, laboratory, and imaging parameters to correlate the histologic findings and arrive at an appropriate clinicopathologic diagnosis.