To give an overview of diagnosis and treatment of salivary gland neoplasms and highlight the contribution of recent literature. The newly adapted Milan classification system for cytologic diagnosis provides risk of malignancy and clinical management strategies for parotid neoplasms with high PPV and NPV. Reconstruction for partial parotidectomy and total parotidectomy defects continues to advance toward greater cosmesis and facial symmetry. New diagnostic advances will aid in clinical decision making and patient management. Surgically based therapy continues to be favored in both benign and malignancy lesions. Management of the neck is important in high grade salivary malignancy and reconstruction of defects should be considered in order to improve cosmetic outcomes.