Parotid gland tumors constitute a heterogeneous group of salivary gland neoplasms and are clinically important because of their close relationship with the facial nerve and their wide histopathological spectrum. Although relatively uncommon in the general population, the parotid gland is the most frequent site among salivary gland tumors. Population-based data suggest an estimated overall incidence of parotid tumors of approximately 4.8 per 100,000 person-years when extrapolated from salivary gland tumor incidence and site distribution, whereas parotid cancer incidence is lower (e.g., about 0.794 per 100,000 person-years in SEER-based analyses).

Objectives: This review aimed to synthesize evidence on the epidemiology, clinical presentation, imaging diagnosis, histopathological characteristics, surgical outcomes/complications, and recurrence rates of parotid gland tumors.

Methods: A structured literature review was conducted using published studies on parotid gland tumors and salivary gland tumors with parotid-specific data. Evidence was organized into thematic domains: (1) incidence/epidemiology; (2) clinical manifestations and malignancy “red flags” (e.g., pain, facial nerve dysfunction, rapid growth); (3) diagnostic imaging (ultrasound, CT, MRI, and advanced MRI techniques such as DWI/DCE); (4) histopathology of common benign and malignant entities; (5) postoperative outcomes and complications; and (6) recurrence patterns. Key quantitative outcomes reported across studies were extracted and summarized.

Results: The most common clinical presentation was a parotid mass, reported in up to 90.8% of patients in a large surgical cohort. Classical clinical clues of malignancy (rapid growth, skin infiltration/ulceration, cervical lymphadenopathy, pain, facial nerve palsy) may be absent at initial assessment in a substantial proportion of cases. Imaging plays a pivotal role in risk stratification and surgical planning. MRI showed higher discriminatory performance than ultrasound for benign–malignant differentiation (AUC 0.899 vs 0.702), and combined ultrasound–MRI achieved high specificity (94.8%) with a high negative predictive value. Histopathology remains the reference standard, encompassing frequent benign tumors (pleomorphic adenoma, Warthin tumor) and diverse malignancies (mucoepidermoid carcinoma, adenoid cystic carcinoma, acinic cell carcinoma, carcinoma ex pleomorphic adenoma). Surgical management is the cornerstone of treatment; pooled complication rates after parotidectomy include hematoma 2.9%, surgical site infection 2.3%, sialocele 4.5%, salivary fistula 3.1%, and sensory disturbances 33.9%. Long-term sequelae such as Frey syndrome may be frequent. Recurrence is generally low for benign tumors but varies by surgical technique and tumor type; markedly higher recurrence has been reported in malignant entities such as carcinoma ex pleomorphic adenoma.

Conclusions: Parotid gland tumors require a comprehensive diagnostic approach because clinical findings alone may not reliably exclude malignancy. Ultrasound is useful as an initial assessment, while MRI—particularly when combined with ultrasound and advanced sequences—improves preoperative discrimination and anatomical mapping. Surgery provides favorable outcomes overall, but counseling regarding facial nerve-related morbidity, sensory disturbances, Frey syndrome, and recurrence risk is essential. Further standardized, high-quality studies are warranted to optimize diagnostic algorithms and compare surgical techniques with long-term oncologic and functional outcomes.