Background: Parotid gland tumors constitute the majority of salivary gland neoplasms, most of which are benign. Surgical excision remains the primary treatment modality; however, the optimal extent of parotidectomy continues to be debated due to concerns regarding facial nerve preservation, postoperative complications, and oncological adequacy. Superficial conservative parotidectomy (SCP) is commonly advocated for benign superficial lobe tumors, whereas total conservative parotidectomy (TCP) is preferred for malignant or deep lobe lesions. Comparative evidence evaluating outcomes of these two approaches in routine clinical practice remains limited. Objectives: To compare the outcomes of superficial conservative parotidectomy and total conservative parotidectomy with respect to operative parameters, postoperative complications, facial nerve function, and tumor recurrence, and to analyze the clinicopathological profile of parotid gland tumors. Methods: This comparative study was conducted over 18 months in a tertiary care teaching hospital and included 30 patients with parotid gland tumors. Patients were allocated into SCP (n = 15) and TCP (n = 15) groups based on tumor characteristics and lobe involvement. All patients underwent clinical evaluation, ultrasonography, and fine needle aspiration cytology prior to surgery. Operative time, tumor size, postoperative complications, facial nerve function using the House–Brackmann grading system, and recurrence were assessed. Data were analyzed using appropriate statistical tests, with p < 0.05 considered statistically significant. Results: Benign tumors constituted 90% of cases, with pleomorphic adenoma being the most common histological type, and a female predominance was observed. Mean tumor size and operative time were significantly lower in the SCP group compared to the TCP group (p < 0.001). Immediate facial nerve neuropraxia and permanent facial palsy were significantly more frequent following TCP (p = 0.020 and p = 0.040, respectively). The SCP group demonstrated significantly better postoperative facial nerve function based on House–Brackmann scores (p < 0.001). Other complications were more common in the TCP group but did not reach statistical significance. One case of tumor recurrence was observed in the TCP group. Conclusion: Superficial conservative parotidectomy offers superior functional outcomes, shorter operative time, and fewer postoperative complications for benign parotid tumors confined to the superficial lobe. Total conservative parotidectomy remains appropriate for malignant or deep lobe tumors to ensure oncological clearance. Surgical approach should be individualized based on tumor characteristics.