Drooling generally arises as a result of neurologic or muscular impairments, especially in subjects affected by cerebral palsies. It has never previously been described in patients with ring chromosome 21 syndrome. We describe the video-assisted surgical rehabilitation of the left parotid duct in a child with ring chromosome 21 syndrome and a persistent and painful swelling of the left parotid region after the surgical ligation of the Stensen ducts because of drooling. The diagnosis of Stensen duct dilatation as a result of iatrogenous complete distal acquired atresia was made by means of clinical and magnetic resonance evaluations. Video-assisted sialoendoscopical surgical rehabilitation of the left parotid duct was successfully performed; based on this experience, this minimally invasive procedure is preferred before traditional invasive parotid surgery in these cases. Other therapeutical options such as botulinum toxin therapy might be considered for the management of drooling in such young patients.