Sever hypercalcemia is by means of definition, Calcium stage above 14 mg/dirrespective of the signs and symptoms and it calls for immediately intervention.Standard of care is hydration, calcitonin, and bisphosphonate.Calcitonin is anticipated to lower the calcium over 12 to 48 hours andpamidronate or zoledronic Acid are expected to paintings DÑ–er 48 hours.Ðe modern treatment requires health facility admission commonly for theintravenous fluid administration and the bisphosphonate infusion.Parathyroid adenoma is the most not unusual cause of number onehyperparathyroidism and hypercalcemia in an outpatient setting. Ðetreatment of parathyroid adenoma with sever hypercalcemia is surgicalelimination of the parathyroid adenoma DÑ–er managing the immediatelyhypercalcemia. (PEA) iscurrently used for treatment of conditions, recurrent number onehyperparathyroidism in affected person with MEN 1 and secondaryhyperparathyroidism in patient with renal failure.Recent evaluation of the Mayo Clinic PEA treatment of recurrent PHPin affected person with MEN 1 [1] concluded that PEA is an eوٴective remedyfor attaining normocalcemia in most people of the affected person s withMEN 1. Hyper vascularity of the parathyroid adenoma was correlatedwith the success of PEA of the parathyroid adenoma in number onehyperparathyroidism.PEA of secondary hyperparathyroidism in affected person with renal failurebecome additionally extra a hit if the enlarged parathyroid gland changed into hypervascular.