The classical actions of parathyroid hormone (PTH) are well recognized, but its effects on other target tissues, such as the cardiovascular system, are less appreciated. Several studies have evaluated the effects of PTH in patients with primary hyperparathyroidism in order to understand potential cardiovascular effects in terms of hypertension, cardiovascular mortality, left ventricular function, and endothelial function. We review these studies and evaluate the cellular mechanisms that may affect these outcomes.