Objectives. The purpose of the current study was to compare outcomes and complication rates of sialolithiasis treated with intracorporeal holmium laser lithotripsy in conjunction with salivary endoscopy with those treated with simple basket retrieval or a combined endoscopic/open procedure. Study Design. Case-comparison study. Setting. Tertiary hospital. Methods. Review of prospectively collected data of patients who underwent treatment for sialolithiasis by the senior author during 2011 to 2013. Patient demographics, operative techniques, surgical findings, clinical outcomes, and complications were recorded. Additional information regarding symptoms and satisfaction with treatment was obtained via standardized telephone questionnaire at the time of the data analysis. Results. Thirty-one patients were treated for sialolithiasis. Sialoliths averaged 5.9 mm in size (range, 2-20 mm) and were comparable between both groups. Sixty-eight percent were in the submandibular gland (n = 21), with the remaining 32% in the parotid gland (n = 10). Fifty-two percent of patients (n = 16) were treated endoscopically with intracorporeal holmium laser lithotripsy, while the remaining 48% (n = 15) were treated with salivary endoscopy techniques other than laser lithotripsy. Successful stone removal without additional maneuvers occurred in 81% of the laser cases and 93% of the nonlaser group. Patients in the laser group reported an average improvement of symptoms of 95% compared with 90% of the nonlaser group when adjusted for outliers. Complications in all patients included ductal stenosis (n = 2) and salivary fistula (n = 1). Conclusion. The results of our series show favorable results with the use of intracorporeal holmium laser lithotripsy for the endoscopic management of sialolithiasis with minimal adverse events. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014.