Purpose: The role of rapid intraoperative parathyroid hormone (ioPTH) testing is to improve the rate of curative parathyroid surgery, limit unnecessary dissection and reduce operative time. It is internationally accepted as a useful adjunct during parathyroidectomy, but is not widely utilised in Australia. Methods: This study describes the process of establishing a clinical protocol for ioPTH testing in a single private hospital. Surgeons, theatre staff and scientists worked together to devise a mutually acceptable standard operating procedure and regularly reviewed performance over twelve months. Our aim was to create a practical ioPTH reporting algorithm, thirty minutes from taking the venous sample to calling the surgeon with a result. Results: Forty-two patients underwent parathyroid surgery, by two surgeons, at a single institution (Nov 2023-Oct 2024). The majority (95.2%) had primary hyperparathyroidism. ioPTH was utilised in all cases. The mean time taken to obtain the pre-excision ioPTH sample was 33.2 minutes and the 10 minute post excision ioPTH sample was 32.4 minutes. Eight patients had more than two samples drawn during surgery, when inadequate parathyroid hormone decay prompted the suspicion of multigland disease or non-curative excision. The average % decay between the PRE- and POST-10 samples was 67.6% (- ie > 50%). The overall surgical cure rate was 95.2% (42/43 patients). Conclusion: The use of ioPTH in Australian hospitals is feasible and highly effective in reducing the incidence of non-curative surgery. However, it requires a motivated team to initiate and maintain the dedicated programme. Routine use should be considered by all Australian endocrine surgeons.