Objective To analyze the changes of serum parathyroid hormone (PTH) in patients with secondary hyperparathyroidism (SHPT) after parathyroidectomy (PTX) and patients' subjective evaluation of surgical efficacy and adverse effects. Methods A retrospective analysis was conducted on the clinical data of 57 SHPT patients who underwent PTX at Department of Thyroid, Breast and Hernia Surgery of The Second Affiliated Hospital of Naval Medical University from Jan. 2011 to Mar. 2021, with a follow-up ＞1 year. Serum PTH level was recorded preoperatively and during follow-up. Patient satisfaction data regarding surgical efficacy were collected and the distribution intervals of postoperative PTH level were compared among patients with different satisfaction. Additionally, patient satisfaction was analyzed in relation to the PTH target values recommended by different current guidelines. Results Among the 57 patients, 4 underwent reoperation due to recurrence. In the remaining 53 patients, no significant difference was observed in PTH levels between postoperative day 1 and the last follow-up visit (P=0.119); however, PTH levels at both time points were significantly decreased compared with the preoperative level (both P＜0.05). During the follow-up, 23 of the 53 patients had a decrease in PTH level and 30 had an increase, with a significant difference in postoperative PTH change between them (P＜0.05). There was no linear regression relationship between the PTH level on the first postoperative day and the postoperative PTH change in the patients with PTH elevation (P=0.478). Based on satisfaction levels with the surgical efficacy, the patients were categorized into very satisfied group (n=24), moderately satisfied group (n=27), and dissatisfied group (n=2). The postoperative PTH levels in the very satisfied group were concentrated at lower levels, while those in the moderately satisfied group showed more dispersed distribution, with the median values being 23.21 and 24.71 pg/mL on the first postoperative day, and 36.54 and 68.30 pg/mL at the final follow-up, respectively. The PTH levels in the dissatisfied group were distributed at two extremes. When postoperative PTH was evaluated using the Kidney Disease: Improving Global Outcomes guideline (target value: 130-650 pg/mL) or the Japanese Society for Dialysis Therapy guideline (target value: 60-240 pg/mL), the proportion of patients within the PTH target range was relatively low among the patients with high satisfaction, whereas the proportion below the target value was relatively high. When postoperative PTH was evaluated using the normal PTH reference value (15-65 pg/mL), the proportion of patients achieving the target PTH level was significantly increased among patients with high satisfaction. Conclusion PTH levels in SHPT patients significantly decrease after surgical treatment and subsequently exhibit dynamic trend. Maintaining the postoperative PTH target value within a range lower than that recommended by current mainstream guidelines may lead to better clinical experiences for patients.