Objective Hyperparathyroidism has a variable presentation. Clinical manifestations, histopathology, and treatment of patients with hyperparathyroidism in Bucaramanga City, Colombia, were analyzed. Method A descriptive study was conducted. Results Twenty‐five patients (F:M ratio 1.5:1) with age ranging from 14 to 81 years (mean, 52.1 ± 18.15 years) were analyzed. Skeletal/osseous manifestations (100%), renal calculi (66%), muscle weakness (40%), and pruritus (24%) were the most common symptoms with mean duration of 24.2 months. Biochemical features included hypercalcemia (total corrected calcium 13.83 mg/dL), and high parathyroid hormone (mean, 1095.7). Twelve of 25 patients had primary hyperparathyroidism, 11 out of 25 secondary hyperparathyroidism, and 2 had tertiary hyperparathyroidism. A single patient had multinodular thyroid goiter. Parathyroidectomy was performed by Kocher’s incision in 21 out of 25 cases and minimally invasive open approach in 4 out of 25 cases. The following types of interventions have been performed: tumor resections (15/25), subtotal parathyroidectomies (6/25), and total parathyroidectomies (4/25). A total thyroidectomy was performed in the patient with associated thyroid disease (1/25). Histopathological examination revealed parathyroidian adenoma in 40% of patients, parathyroidian hyperplasia in 48%, and parathyroidian carcinoma in 4%. All symptoms and hypercalcemia resolved with the treatment. Such complication was observed in a case of hungry bone syndrome. No patients died within 15 months of follow‐up. Conclusion We described the clinical and histopathological features of patients with hyperparathyroidism in Colombia. Although pathologic features of parathyroid carcinoma are diagnostically reliable, those of the more commonly encountered lesions of adenoma and hyperplasia may be overlapping and, therefore, indistinctive, more so if only a single gland is available for examination.