Primary hyperparathyroidism is an endocrine disorder with muti-system involvement. The clinical condition is dealt by multi-speciality department. Parathyroid adenoma is the principal cause of primary hyperparathyroidism. Parathyroid neoplasm is a spectrum disorder and has been classified into following: Parathyroid hyperplasia, parathyroid adenoma and parathyroid carcinoma. Hypercalcemia and raised parathormone are characteristic determinants of primary hyperparathyroidism. According to literature, a giant parathyroid adenoma is defined as one weighing more than 3.5 g. To the best of our knowledge, this first case report in south asia presenting as cervical swelling with stridor. Giant parathyroid adenoma weighed 184 g in our patient. Rise in parathyroid hormone level leads to variable systemic symptoms primarily due to hypercalcemia. Constipation, fatigue, weakness, recurrent episodes of renal stones, brown tumors are some of common systemic manifestation. We present a case report of 56 years female with cervical swelling and breathing difficulty at presentation.