Objective：To investigate the value of ultrasound versus radionuclide imaging in the diagnosis of parathyroid adenoma （PTA）. Methods：A retrospective analysis was performed for 150 patients who were found to have parathyroid nodules on ultrasound or radionuclide imaging in The First Affiliated Hospital of Chongqing Medical University from June 2012 to July 2016，among whom 89 patients were diagnosed with PTA by postoperative pathology. The imaging findings of the lesions on ultrasound and radionuclide imaging were summarized to analyze the advantages of these two methods. Results：Both ultrasound and radionuclide imaging showed the presence of PTA，with sensitivities of 86.9% and 66%，respectively，and specificities of 88.1% and 70.2%，respectively，and there was a significant difference between the two methods（P=0.000）. According to the receiver operating characteristic（ROC） curve，the 95% confidence interval（CI） for the area under the ROC curve（AUC） of ultrasound was 0.464-0.588，while that of radionuclide imaging was 0.310-0.437. Ultrasound combined with radionuclide imaging had a sensitivity of 96.7% and a specificity of 90.1% in the diagnosis of PTA，and the 95% CI for the AUC of this combination was 0.542-0.658；there was a significant difference in 95%CI for AUC between ultrasound combined with radionuclide imaging and ultrasound alone（P=0.005）. Conclusion：Ultrasound has higher sensitivity and specificity than radionuclide imaging in detecting PTA，and ultrasound combined with radionuclide imaging can further improve detection rate.