Aims and background: Celiac disease (CD) is a malabsorptive disorder leading to cases of secondary hyperparathyroidism. It is uncommon for primary hyperparathyroidism (PHPT) and tertiary hyperparathyroidism (THPT) to be associated with CD, and it can be challenging to distinguish between the two conditions. Case description: Here, we report a case of CD with chronic liver disease (CLD) that had a normal renal function test and a left inferior parathyroid adenoma (LIPA) that was discovered incidentally. A successful focused parathyroidectomy was performed, and the patient is eucalcemic 2 years after the procedure. The conundrum was whether to contribute it to PHPT or THPT. Conclusion: Celiac disease can be associated with several forms of hyperparathyroidism. It is an arduous task to differentiate between PHPT and THPT associated with CD. Clinical significance: A thorough evaluation is necessary for cases of HPT associated with CD for excellent outcomes.