Parathyroid carcinoma is a rare entity accounting for only 0.5% to 5% of all cases of parathyroid neoplasm. Its usual clinical presentation is that of primary hyperparathyroidism with elevated serum calcium and parathyroid hormone (PTH). A 62-year-old male was presented with sore throat and anterior neck mass with normocalcemia and high level of PTH. The patient underwent left parathyroidectomy and diagnosed as parathyroid carcinoma with cystic change and internal hemorrhage. Parathyroid carcinoma, early surgery has proven to be the only curative method. En bloc excision of primary lesion with removal of involved structures should be mandatory.