Secondary hyperparathyroidism is a common complication in patients with chronic renal failure and can cause hypercalcemia, muscle pain, weakness, arteriosclerosis leading to serious cardiovascular disease. Surgical removal of the parathyroid gland is the way of treatment when medical treatment could not control secondary hyperparathyroidism-associated complications. In recent years, advances in minimally invasive surgery provide less scarring surgical incision. This article will describe endoscopic assisted minimally invasive parathyroid surgery for patients with chronic renal failure-related secondary hyperparathyroidism. This surgical technique offers a similarly success rate and has superior cosmetic results. The indications of parathyroidectomy, surgical prognosis and care are also discussed.