Background. Mucosa associated lymphoid tissue (MALT) lymphoma has been noted to involve the salivary glands in chronic inflammatory conditions such as Sjogren's syndrome and in HIV infection. Methods and Results. The authors encountered a patient with bilateral cystic changes in the parotid glands which proved to be due to MALT lymphoma. The clinical course, histopathology, and treatment options of MALT lymphoma in the salivary gland are discussed in detail. Conclusion. This malignant entity should be considered in the differential diagnosis of refractory cystic lesions of the salivary glands. © 2001 John Wiley & Sons, Inc.