Management of humoral hypercalcaemia of malignancy (HHM) refractory to bisphosphonates, or where their use is contraindicated, can be challenging. We present a case of PTHrP-secreting metastatic pancreatic neuroendocrine tumour (NET) with recurrent hypercalcaemic crises and renal failure. The challenges of managing hypercalcaemia in the presence of kidney disease are highlighted in this case.This article is protected by copyright. All rights reserved.