Adenoid cystic carcinoma (ACC) is unique among salivary gland tumors in both its natural history and in its response to nonsurgical treatment methods (ie, radiation and chemotherapy). The chemotherapeutic agent, cisplatin, seems to be unique in its ability to affect ACC. It might be that ACCs of the minor salivary glands are especially vulnerable to the intra-arterial method of administering this drug, because there are accessible feeding vessels to most locations in which these tumors occur. We have treated four patients with advanced ACC with intra-arterial cisplatin. The responses suggest that this method may be a useful adjunct in the management of this tumor both as a preoperative and as a palliative measure.