We describe a seemingly unaffected 76-year-old female who presented to our Genetics Clinic with a family history of primary hyperparathyroidism and the identification of a pathogenic <i>MEN1</i> variant.<h4>Case presentation</h4>The patient was a 76 year-old woman who appeared to be unaffected. The gene discussed is MEN1; the disease is primary hyperparathyroidism.