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In evaluating primary parathyroid adenomas with high-resolution color Doppler sonography, initial detection relied on the observation of a hypoechoic soft tissue mass adjacent to the thyroid gland. Using color Doppler sonography, many adenomas had a demonstrable blood supply from the inferior thyroidal artery branches, identified as a vascular arc surrounding the gland from 90 to 270 degrees. The vascular arc assists the interpreter with establishing the nature of the mass, differentiating it from masses such as regional lymph nodes, which demonstrate hilar flow. Sixty-three percent (20 of 32) of parathyroid adenomas had a color arc. The identification of a vascular arc is a useful adjunctive finding, improving diagnostic specificity and quickly confirming the diagnosis of parathyroid adenoma.