Background: Post-operative hypocalcaemia remains a significant complication of thyroid and parathyroid surgery. While high-volume centres have access to intra-operative techniques such as parathyroid hormone sampling and frozen section to aid parathyroid identification, regional centres frequently lack immediate access to these resources. The PTeye device (Medtronic) utilizes parathyroid autofluorescence to provide intra-operative tissue differentiation. While validated in specialized centres, its utility in lower-volume settings is less defined. Methods: We have performed a case series of four patients undergoing thyroid or parathyroid surgery our regional institution. The PTeye device was utilised as an adjunct to classical identification techniques. In this paper, we report the pre-operative investigations, operation findings and post-operative histological and pathological results. We evaluated the device's ease of implementation, intra-operative utility, and limitations in a setting without ad hoc access to frozen section or rapid parathyroid hormone analysis. Results: The PTeye was easily integrated into the surgical workflow with negligible setup time, comparable to standard nerve monitoring systems. Surgeons reported that the device served as a useful confirmative tool, increasing confidence in parathyroid preservation. However, the device demonstrated limitations in detecting intrathyroidal parathyroid glands, where probe contact could not be achieved. Conclusion: The PTeye is a promising adjunct for thyroid and parathyroid surgery in regional settings where resource-heavy investigations are limited. While it augments surgical decision-making and confidence, it does not replace the necessity for classical anatomical knowledge and surgical technique.