Primary hyperparathyroidism (PHPT) is a condition characterized by the parathyroid glands’ overproduction of parathyroid hormone (PTH). These increases calcium levels in the blood, leading to various symptoms and complications. Cinacalcet is a promising therapeutic option for patients with PHPT who are unable or unwilling to undergo surgery. It effectively reduces serum calcium and PTH levels, improving biochemical markers of bone turnover and renal function. However, more research is needed to determine the optimal dosage, duration, and long-term effects of cinacalcet treatment in this patient population. Clinicians should carefully consider the risks and benefits of cinacalcet therapy individually and involve patients in shared decision-making.