Objective To evaluate the value of ultrasonography in the differential diagnosis of benign and malignant salivary gland neoplasms. Methods 124 patients with salivary gland tumors included 111 benign tumors and 13 malignant neoplasms were proved by surgical histopathology after the ultrasonography process. And the parameters including gender, age, maximum diameter, height/width ratio, number of lesions, echogenicity, shape, margin, posterior echogenicity, cystic degeneration, calcification and blood flow were retrospectively analysed. The receiver operating characteristic (ROC) curve was plotted to calculate the diagnostic efficacy of the parameters. Results There were statistically significant differences in the parameters of margin and calcification between the two groups (P＜0.05). The sensitivity, specificity, and accuracy of unclear margin in differentiation of malignant from benign neoplasms in the salivary gland were 46.15%, 95.50%, and 90.32%, respectively. The area under the curve was 0.708. Differentiating diagnoses between malignant and benign neoplasms with calcification resulted in a sensitivity of 30.77%, specificity of 72.97%, accuracy of 68.55%, and the area under the curve of 0.64. There were no statistically significant differences in gender, age, maximum diameter, height/width ratio, number of lesions, echogenicity, shape, posterior echogenicity, cystic degeneration and blood flow the groups (P＞0.05). Conclusion: It is difficult to diagnose salivary gland tumors by ultrasonography. Malignant neoplasms should be considered when the neoplasms have unclear boundaries and multiple calcifications.