Several minimally invasive procedures have been described over the past 3 years for the treatment of sporadic primary hyperparathyroidism (PHPT). These techniques (totally endoscopic, video assisted and radio guided) have been demonstrated to be feasible and safe, but the surgeon should be well trained to obtain the best results with these approaches. Not all patients are eligible for minimally invasive procedures. The results are comparable to those of conventional surgery with advantages in terms of cosmetic result and reduced post-operative pain. These procedures should be considered to be a valid option by surgeons dealing with patients with primary hyperparathyroidism.