The purpose of this retrospective review is to study the management of a rare malignant tumor of the parotid gland, the acinic cell carcinoma. Incidence, pathology, clinical findings, and diagnosis are reviewed. Twenty-five patients were seen at the British Columbia Cancer Agency (BCAA) for initial treatment, recurrent disease or follow-up during the period 1958-1990. Twenty-two acinic cell carcinomas (ACC) occurred in the parotid gland. Surgical treatment regimens for parotid ACC ranged from local excision to radical excision. Local excision is not advised but superficial parotidectomy alone appears to have been adequate treatment for small superficial tumors. Eleven of 22 patients received radiotherapy. Indications for adjuvant postoperative radiotherapy are given. Nine patients with primary tumors treated with combined therapy are alive and disease-free with a mean follow-up of 10.7 years. Postoperative radiotherapy appears to be effective in eradicating microscopic residual disease although long-term follow-up is necessary to make these results clinically significant.