Coincidence of primary hyperparathyroidism and thyroid nodules is quite frequent. This is challenging for clinical diagnosis and treatment. We reviewed the records of patients who underwent surgery for primary hyperparathyroidism. Among 52 such cases, thyroidectomy was performed in seven patients (13%) at the same time. Papillary thyroid cancer was detected in five patients (9.6%) as a result of pathologic examination. Two patients were diagnosed with unifocal micro-papillary cancer and these patients underwent unilateral thyroid lobectomy. The remaining three patients, who had thyroid papillary cancer underwent bilateral total thyroidectomy. Likelihood of thyroid cancer should be considered in cases of primary hyperparathyroidism with coexistent thyroid nodules, and a detailed examination should be performed in preoperative period. These will lead to reduce morbidity and lower cost resulting from a second surgery.