Background: Secondary hyperparathyroidism is a major problem in chronic kidney disease patients, resulting in skeletal complications including enhanced osteoclast activity with accelerated bone turnover and osteitis fibrosa cystica. Objective: Studying the effect of total parathyroidectomy without autoimplantation on PTH level, and state of parathormone activity in hemodialysis patients. Patients and Methods: Thirty four hemodialysis patients with secondary hyperparathyroidism were subjected for follow up as regard calcium, phosphorus, parathormone (PTH) level, post total parathyroidec-tomy without auto implantation between July 2013 and December 2015 after failure of medical treatment. Results: The studied patients had a mean age of 52.3 ±5.6 years. They were 15 males (44.1 %) and 19 females (55.8%). Mean of hemodialysis duration was 12.4 ±3.8 years.There was a significant decline of the postoperative parathyroid hormone levels when compared with their preoperative assessments. After 6 months 67.6 % had PTH levels of 3-8 folds more than upper normal of assay, while 5.9% had PTH level below 100 pg-ml, and 26.5 % have PTH level more than 8 folds the upper normal of assay,and symptoms of recurrent hyperparathyroidism. Conclusion: Total parathyroidectomy without autoimplantation was associated with a low rate of hypopara-thyroism in hemodialysis patients.