Abstract：[Objective] To analyze the imaging features of brown tumor caused by primary hyperparathyroidism（PHPT）and improve the diagnostic ability of this disease and explore the method of surgical treatment. [Methods] The clinical, biochemical and imaging data of 5 patients with brown tumor caused by primary hyperparathyroidism were analyzed retrospectively. [Results] 5 cases of parathyroid disease resection, 4 cases of parathyroid adenoma, 1 case of parathyroid hyperplasia. Four cases of brown tumor were multiple, and one case was solitary, most of which were found in ribs. CT showed osteolytic destruction of bone, most of which were homogeneous and enhanced significantly after enhancement. One case had low signal on T1WI and high signal on T2WI with homogeneous signal. Multiple renal calculi occurred in 4 cases, and pathological fracture occurred in 2 cases. Parathyroid hormone (PTH) was significantly increased in 5 cases, with an average of 1246.7 pg / ml. the serum calcium level was increased, with an average of 3.25 mmol / L, and the serum phosphorus level was decreased, with an average of 0.69 mmol / L. [Conclusion] Brown tumor often occurs in patients with hyperparathyroidism, which has certain characteristics in imaging. Combined with blood biochemical examination results and clinical symptoms, we can make correct diagnosis, surgical resection of parathyroid gland, surgical symptomatic treatment, and achieved good results.