Objective: Sialolithiasis is a frequent condition seen and treated by otolaryngologists. Salivary stones typically affect the submandibular and parotid glands and can arise from electrolyte disturbances, stasis, or a chronic infectious origin. Primary hyperparathyroidism (pHPT) is associated with ‘stone disease’, but this has been universally considered to refer to kidney stones. Few case reports exist reporting the relationship between pHPT and sialolithiasis. Design: A retrospective patient series from a single surgical practice. Setting: A single-specialty referral clinic with a practice limited to parathyroid surgery. Main Outcome Measure(s): Descriptive data and statistics. Results: We report a series of 18 patients from among 3,000 consecutive patients treated from March 2003 to May 2007. We describe demographics and characteristics of sialolithiasis that occur in the context of underlying pHPT. Conclusion: The parathyroid surgeon should be aware of sialolithiasis as a potential comorbidity for pHPT and manage it appropriately. Conversely, practitioners encountering salivary gland stone disease should at least consider hyperparathyroidism as a possible etiology.

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