Abstract: Objective To report a case of bilateral papillary thyroid carcinoma combined primary hyperparathyroidism caused by multiple parathyroid adenoma, summarize the diagnosis and treatment of this disease to avoid missed diagnosis. Methods Clinical characteristics, diagnosis and treatment of a patient with bilateral papillary thyroid cancer combined primary hyperparathyroidism caused by multiple parathyroid adenomas in the Fourth Affiliated Hospital of Harbin Medical University in May 2018 were analyzed and related literatures were reviewed. Results The patient was a 61-year-old female and mainly presented with intermittent urination, urgency of urination, and fatigue for 7 years. The diagnosis was "bilateral thyroid occupancy, hyperparathyroidism, parathyroid occupancy". Bilateral total thyroidectomy, bilateral recurrent laryngeal nerve exploration and left parathyroid adenoma resection were performed. PTH was monitored perioperatively, and the level of PTH dropped rapidly after the operation. At 3 days after operation, PTH dropped to the normal level. Postoperative pathological results showed bilateral papillary thyroid carcinoma and parathyroid adenomatous hyperplasia. Conclusion Multiple parathyroid adenomas complicated with thyroid cancer, especially bilateral thyroid cancer, is rare. Surgical excision is the only effective treatment for primary hyperparathyroidism. The thyroid function should be evaluated before operation, and the coexistence of cancers should be excluded to avoid missed diagnosis and secondary operation.