Adenoid cystic carcinoma is an uncommon tumour, which may present in many areas of the head and neck. An analysis is made of 30 cases presenting to the Head and Neck Clinic at St Vincent's Hospital, Sydney. The special characteristics of the pathology of this tumour and its life history are outlined. The clinical presentation and management of tumours in various sites are analysed. As a result of these experiences, recommendations in respect of diagnosis and treatment are made.