Parathyroid lipoadenoma is a rare entity with very few cases reported in the literature. It is defined as a benign neoplasm resembling a hamartoma, featuring both chief cells and significant stromal elements, and may be functioning or non-functioning. Typical presenting symptoms are similar to hyperparathyroidism. Here we present a 43-year-old male with multinodular goiter, experiencing worsening dysphagia, that while undergoing total thyroidectomy, was noted to have an abnormal right inferior parathyroid gland. The patient underwent parathyroidectomy in conjunction with thyroidectomy and was incidentally found to have a parathyroid lipoadenoma. Post-operatively his parathyroid hormone decreased, and he reported no symptoms of hypocalcemia. The patient underwent successful removal of a parathyroid lipoadenoma.