Normal parathyroid glands are very small, measuring approximately 6 mm in the craniocaudal dimension and 3-4 mm in the transverse dimension, with a flattened disk shape. Normal-sized parathyroid glands are not usually identified by most imaging modalities. Therefore, a parathyroid gland that is visible in US is very suspicious for the presence of a pathological entity The role of radiologists in the treatment of parathyroid disease was previously limited to the preoperative localization of hyperfunctioning parathyroid lesions. However, radiologists have been required to play a more active role, because it is increasingly necessary to distinguish parathyroid incidentalomas (PTIs) detected during thyroid ultrasonography (US), from thyroid lesions. In this presentation, we would review the anatomy and pathology of parathyroid glands and the different imaging findings in parathyroid adenomas. We would briefly review the alternative imaging modalities in evaluation of enlarged parathyroid glands as well. We would also review the role of US-guided simple aspiration in Symptomatic nonfunctioning PCs .