eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-08-17 9 11 664 666 10.12691/ajmcr-9-11-12 AJMCR202191112 article Majdi Al Najjar 1 Mousa Suhail Abu Ghoush mousasuhail@hotmail.com 2 Nadeen Elmajed 2 Ahmed Eldimllawi 2 Ahmed Abousalha 2 Yousef almehrzi 2 Endocrine, Zayed Military Hospital, Abudhabi, United Arab Emirates Internal Medicine, Zayed Military Hospital, Abudhabi, United Arab Emirates Hypocalcaemia is a common but transient complication post Parathyroid surgery. In patients who have gone through bariatric surgery including Roux-En-Y the risk increases further. We present a challenging case report of a patient with history of RYGB who underwent parathyroidectomy and consequently developed refractory hypocalcaemia. Hypocalcaemia was managed conservatively initially but subsequently required higher doses of both intravenous and oral calcium along with teriparatide. Patients post Bariatric surgery including those who have undergone Roux-en-Y who are proceeding with Parathyroid procedures should be followed up closely for hypocalcaemia. http://pubs.sciepub.com/ajmcr/9/11/12/ajmcr-9-11-12.pdf Roux-en-Y post parathyroidectomy hypocalcaemia refractory teriparatide bariatric surgery