Abstract Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterized by inappropriate parathyroid hormone (PTH) secretion leading to chronic hypercalcemia. Acute pancreatitis is a rare but potentially severe complication of PHPT. We report three cases in which acute pancreatitis was the revealing manifestation of primary hyperparathyroidism. These observations emphasize the importance of systematically investigating metabolic causes, particularly hypercalcemia, in cases of acute pancreatitis with no obvious etiology.