The subtotally nephrectomized rat has often been used to investigate the etiology and treatment of secondary hyperparathyroidism (2°HPT), but it has been used less frequently to study the effects of 2°HPT on bone. The recent development of a reliable and specific rat parathyroid hormone (PTH) immunoradiometric assay has provided an opportunity for a thorough investigation of the relationship between circulating, biologically active PTH, and the skeletal abnormalities that occur in chronic renal insufficiency (CRI). Rats were 5/6 nephrectomized (Nx) or sham operated and fed diets with varying levels of Ca and P for 12–14 weeks to induce differing magnitudes of 2°HPT. Parathyroid gland volume increased by 80%–90% in 5/6 Nx rats in the mild and moderate 2°HPT groups (2.3- and 7.7-fold higher PTH levels, respectively) and by 3.3-fold in the severe 2°HPT group (12-fold increase in PTH). The increases in gland volume were caused primarily by cell hyperplasia. Mild 2°HPT resulted in a 12% decrease in bone mineral density (BMD) across the entire femur, increased osteoclast numbers (N.Oc), unchanged osteoblast numbers (N.Ob), and decreased cancellous bone volume (Cn.BV) in the tibial metaphysis but, apart from increased marrow area, no major changes in cortical bone at the tibio–fibular junction. Moderate 2°HPT was associated with no changes in femoral BMD, or in tibial Cn.BV, but N.Ob and bone formation rate (BFR) were markedly elevated. Increased periosteal, intracortical, and endocortical BFR and turnover were evident, and contributed to increased cortical porosity (Ct.Po). The changes were exaggerated in the severe 2°HPT group; BMD was lower in the proximal, but higher in the distal femur, and Cn.BV, N.Ob, N.Oc, and BFR were increased by six-, seven-, three-, and 30-fold, respectively. Endocortical BFR was elevated 31-fold and the extensive Ct.Po (10%) decreased bone strength. However, Ct.Po was not apparent until PTH levels exceeded 500 pg/mL. Thus, in rats with CRI of similar magnitude, progressive 2°HPT is associated with dramatically different effects on bone. Mild 2°HPT caused loss of cancellous and endocortical bone, and moderate 2°HPT tended to maintain both types of osseous tissue, whereas PTH levels >500 pg/mL resulted in substantial cortical bone loss, but cancellous bone gain.