Primary Sjögren's syndrome (pSS) is a complex systemic autoimmune disease primarily characterised by a focal chronic inflammation of glandular parenchyma, with chronic and persistent involvement of major salivary gland remaining a key element of the disease. Indeed, classification criteria proposed for pSS have always included items for histological and/or imaging salivary gland assessment. Over time, the approach to the definition of glandular involvement in pSS is constantly evolving. In this review we will therefore illustrate the state of the art of imaging techniques in pSS, focusing on conventional and novel modalities and discussing their advantages, drawbacks and possible future developments.