The validation of a high-performance liquid chromatographic method for the simultaneous determination of low level cotinine and 3-hydroxycotinine in human saliva is reported. Analytes and deuterated internal standards were extracted from saliva samples using automated solid-phase extraction, the columns containing a hyper cross-linked styrene-divinylbenzene copolymer sorbent, and analysed by reversed-phase liquid chromatography with tandem mass spectrometric detection (LC-MS-MS). Lower limits of quantitation of 0.05 and 0.10 ng/ml for cotinine and 3-hydroxycotinine, respectively, were achieved. Intra- and inter-batch precision and accuracy values fell within +/-17% for all quality control samples, with the exception of quality control samples prepared at 0.30 ng/ml for 3-hydroxycotinine (inter-day precision 21.1%). Results from the analysis of saliva samples using this assay were consistent with subjects' self-reported environmental tobacco smoke (ETS) exposures, enhancing the applicability of cotinine as a biomarker for the assessment of low level ETS exposure.