Acinic cell carcinoma metastasising to the spine is rare and has been described only once before in the literature. Its metastasis to other organs such as the regional lymph nodes, lungs and orbit have all been described, but the simultaneous occurrence of lymph nodal, pulmonary and spinal spread in a single patient has not been recorded. We believe this 40-year-old man to be the first reported case of incompletely resected acinic cell carcinoma of the parotid gland metastasising simultaneously to regional lymph nodes, upper lobes of both lungs, sphenoid bone and dorsal spine with neurological deficits. This case report stresses the need for postoperative radiotherapy following incomplete resection of the primary tumour. A careful watch for distant metastasis is also of paramount importance at follow-up.