Among 1,500 parotid sialography examinations, the diagnosis of a parotid mass caused by a prominent transverse process of the atlas was made in 18 patients. The diagnosis was confirmed in one patient who insisted on surgical exploration. The remaining 17 patients required no surgical procedure. Many head and neck surgeons have unwittingly operated on such cases with frustrating results. Hopefully, roentgenographic findings will assist in the confirmation of the diagnosis and eliminate the need for such operations.