Cryopreservation of parathyroid tissue is indicated when there is a potential risk of postoperative permanent hypoparathyroidism. This chapter reviews the current approach to parathyroid cryopreservation and autotransplantation, and the accepted methods to analyze the preservation of cell histoarchitecture and to predict the functional response after different cryopreservation periods. The published clinical results after autotransplantation of cryopreserved parathyroid tissue are reviewed, pointing out the relevance of quick laboratory processing of the fresh surgical specimen and the better functional response obtained transplanting tissue cryopreserved for less than 2 years. The diverse opinions regarding cost-effectiveness of an institutional parathyroid cryopreservation bank are discussed.