Parathyroid adenoma is the first etiology of primary hyperparathyroidism althrough the majority of patients with primary hyperparathyroidism have a relatively asymptomatic benign disorder. There are patients who have a more aggressive disorder. We report a case of 41 years old man whose primary hyperparathyroidism was discovered through exploration of recurrent ureteral stone associated with severe hypertension. The diagnosis was set up on high level serum calcium and low serum phosphorus with very elevated level of parathyroid hormone. Adenome was localised by ultrasound examination. The patient underwent successfully surgery and the pathological study confirm the diagnosis. This case illustrate the importance of investing earlier ureteral recurrent stone to prevent severe complications of primary hyperparathyroidism.