The enlarged parathyroid glands associated with chronic renal failure were recognized during the 1930's. The number of patients on long-term hemodialysis due to chronic renal failure is steadily increasing and the hyperparathyroid state certainly became a clinical problem in the dialysis population. The physiologic mechanisms leading to secondary hyperparathyroidism are multifactorial with renal phosphate retention, skeletal resistance to parathyroid hormone (PTH) action and impairment vitamin D metabolism being some of the known factors. Despite intensive medical management however inadequate control of parathyroid hyperplasia may necessitate surgical intervention. The goal of surgical therapy is to resect sufficient tissue to reverse the hyperparathyroidism without rendering the patient permanently hypoparathyroidism. We experienced a case of secondary hyperparathyroidism and reported its result of total parathyroidectomy, autogenous transplantation and cryopreservation of parathyroid gland.