Objective To analyze the echocardiography characteristics of primary hyperparathyroidism(PHPT) and discuss the related factors with the cardiac structure and functions. Methods Left ventricular end-diastolic diameter (LVDd), interventricular septum diastolic thickness(IVSdT), E/A and LVEF were measured by echocardiography in 78 patients with PHPT. Left ventricular mass index(LVMI) was calculated. Correltion analysis was made within iPTH, serum Ca₂ levels and echocardiography related indicators. Results The incidences of left ventricular hypertrophy, myocardial or valvular calcification,and reduction of left ventricular diastolic function in observation group were higher than those in control group(P values <0.05). In observation group, IVSdT and LVMI were higher than those in control group(1.19±0.10)cm vs (1.09±0.07)cm,(150.21±45.32) g/m₂ vs (106.21±12.19)g/m₂ (P values <0.05). LVEF: (62.3±7.2)% vs (66.5±3.7)%(P value>0.05). Correlation analysis showed that iPTH levels positively correlated with LVDd, IVSdT, LVMI and negatively correlated with E/A; Ca₂ levels positively correlated with cardiac valvular calcification rate, and negatively correlated with E/A(P value<0.05). Conclusion Changes in cardiac structure and function are more likely to occur in PHPT patients, as left ventricular hypertrophy, diastolic dysfunction, and cardiac valvular calcification rate increasing. These changes may associated with high levels of iPTH and Ca₂ .