Seib CD, Suh I, Meng T, et al. - Researchers conducted this population-based, retrospective cohort study to identify patient characteristics associated with the use of parathyroidectomy for the management of primary hyperparathyroidism (PHPT) in older adults. This investigation used 100% Medicare claims from beneficiaries with an initial diagnosis of PHPT from January 1, 2006, to December 31, 2016. Among 210,206 beneficiaries with an incident diagnosis of PHPT (78.8% women; mean [SD] age, 75.3 [6.8] years), 63 136 (30.0%) had parathyroidectomy within 1 year of diagnosis. The majority of older adults with PHPT in this cohort study did not receive definitive treatment with parathyroidectomy. Nonoperative management was associated with older age, frailty, and multimorbidity, and guideline recommendations had little effect on treatment decisions. More research is needed to identify barriers to surgical care and to develop tools to target parathyroidectomy to the most likely to benefit older adults.