One hundred ninety-four patients with primary malignant tumors of the parotid gland who underwent surgery at the Mayo Clinic (1970 through 1987) are reviewed. Survival patterns were analyzed using the Kaplan-Meier product-limit method that separated histologic results into three significantly different groups. Survival rate was highest for patients with acinic cell, adenoid cystic, and low-grade mucoepidermoid carcinomas; intermediate for patients with high-grade mucoepidermoid carcinomas; and lowest for the remaining six histologic types encountered. Cox multiple linear regression was used to identify patient and tumor characteristics with greatest prognostic significance. In order of decreasing strength, regional metastatic involvement, pain, male gender, grade, stage, and advancing age all demonstrated independent prognostic significance. Fifty-three percent of patients requiring facial nerve sacrifice were asymptomatic at presentation. A high positive correlation was observed between advancing grade and stage.