<p>Transient hypoparathyroidism after total thyroidectomy is one of the most common complications. Though multiple risk factors have been identified, it continues to be the most significant problem. Parathyroid hormone (PTH) cut-off level and the timing of assay in predicting their incidence have been a matter of controversy. The objective is to study the predictive value of serum parathyroid hormone at skin closure in identifying the occurrence of transient hypoparathyroidism (within 2 weeks) in patients undergoing total thyroidectomy and to assess the risk factors involved and Vitamin D levels in these patients. This was a single-centered prospective analytical study where all patients above 18yrs of age undergoing total thyroidectomy were analysed with intact parathyroid hormone (iPTH) levels taken preoperatively, within 10 minutes after thyroid specimen removal and on postoperative day 2 and 14. They were monitored for signs and symptoms of hypocalcemia postoperatively till 2 weeks. Out of 43 patients included, 27 patients (62.79%) developed transient hypoparathyroidism. intact parathyroid hormone (iPTH) levels with a cut-off of &lt;10pg/mL done at the time of skin closure, were significantly lower in hypocalcemic groups with p value &lt;0.001 and had 31% sensitivity and 59% specificity with area under the Receiver Operating Characteristic (ROC) curve 0.6. Thyroid malignancy and the number of parathyroid glands identified intraoperatively were found as the independent risk factors of transient hypoparathyroidism.</p>