A 47-year-old man was admitted with chief complaints of macroscopic hematuria and bone pain. Hypercalcemia still remained after three small papillary tumors on the left retrotrigonal wall of the bladder were resected transurethrally. Some biochemical as well as X-ray examinations thereafter pointed out an association with primary hyperparathyroidism. An adenoma arising from right upper parathyroid gland was found and excised. Then his symptoms, both subjective and objective, were normalized. Six documented cases of primary hyperparathyroidism associated with urological malignancy including our own were found in the Japanese literature.