Of 134 patients with adenoid cystic carcinoma, 58% of the neoplasms occurred in the minor salivary glands, and 42% in the major salivary glands. Metastases and recurrences occurred in 67% of 56 patients in the major salivary gland group, and in 92% of 78 patients in the minor salivary gland group. A major surgical ablative procedure is the treatment of choice in the potentially resectable primary and recurrent tumors. Failure at this stage usually means incurability, but not necessarily failure at good palliation. Irradiation proved to be an effective and indispensable adjunct in management of the majority of these patients. Of the entire group, 25 (20%) were living and free of disease after 15 or more years. The major salivary gland patients enjoyed a significantly better prognosis.