Objective To explore the clinical strategy and efficacy of ultrasound-guided radiofrequency ablation for parathyroid adenoma. Methods Ultrasound-guided percutaneous radiofrequency ablation was used to treat 5 patients with solitary parathyroid adenomas. The ultrasonography of procedured area was closely observed. The symptoms of patients,serum parathyroid hormone (PTH) and electrolytes were compared before and after treatment, and the efficacy and safety were assessed. Results The ablative procedures were successful in all the 5 cases. Intraoperative contrast-enhanced ultrasound revealed that the previous distinct vascularities of the adenomas were completely destroyed. Hoarseness was found in two patients, and they recovered in one week postoperatively. No subcutaneous heamorrhage was found beneath the neck skin or along the puncture tract. And there were no hypoparathyroidism, dysphagia or breathing difficulties. The symptoms of ostealgia, skin itching and vomitting were greatly improved in patients on the next day of operation, with PTH obviously declined (71.4%-94.1%) and serum calcium returned to the normal level. Conclusion Ultrasound-guided percutaneous radiofrequency ablation is safe and effective for parathyroid adenoma, with less trauma and slight complications.