Sialolithiasis of the salivary glands is a benign pathology that occurs most frequently in the submandibular gland because of its anatomic features. Detection of factors on the type of surgical procedure under evaluation [1,2]. The study aim was to evaluate factors influencing treatment methods (organ-reserving procedure vs. salivary gland removal) for sialolithiasis. A retrospective analysis of 114 patients (67M, 47F) with sialolithiasis during last five years (31.01.2005-19.04.2011) was performed. Mean patient’s age was 48.9 ± 1.5 years (range 16-84 years). Duration of symptoms was 375.2 ± 66.6 days. Diagnosis of sialolithiasis was established upon radiographic examinations, USG and CT scan. Stone localization was: right vs. left side - 64 (56.1%) vs. 50 (43.9%), distal part of Wharton duct – 50(46.7%) and glandular (hilar) in 57 (53.3%) cases. Multiple stones (≥ 2) were detected in 31 (28.9%), but giant salivary gland calculi (>15mm, according Bodner L. (2002) definition) – 8(7.3%). For surgical treatment were scheduled 107pts (7 were excluded as high-risk – ASA class 3). In 52 (48.5%) calculi were completely removed by intraoral approach incl. 8 (15.4%) - by fragments. In this group, for 2pts with persistent symptoms salivary gland removal was indicated. Sialoadenectomy as first line procedure was performed in 55 (51.4%) cases. Total number of stones removed during surgery were 158 (mean ± S.D. - 1.48 ± 0.08, from 1 to 5). Mean stones size - 7.8 ± 0.51 (2-18) mm. The results of this study suggest that stone size and number as well as anatomical localization was significant predictors for organ-preserving procedures or salivary gland removal. The palpability of submandibular calculi is the most important factor influencing their successful intraoral removal. Patients with multiple stones and stones in the proximal submandibular duct had a greater frequency of submandibular gland excision, compared to patients with single stones and stones in the distal duct. Moreover, longstanding stones usually produce irreversible damage of salivary glands.