Background: Salivary gland neoplasms are relatively rare tumors of the head and neck, with large tumors being extremely uncommon. Case Report: We report the first published case in the Western World of a massive pleomorphic adenoma of the submandibular gland. Conclusion: Such tumors need to be carefully assessed and treated with surgical excision as they harbour a risk for malignant degeneration. The potential for recurrence following resection mandates ongoing follow-up in this cohort of patients.