BACKGROUND: Excision of the submandibular gland is a surgical procedure often undertaken. As noted in the text that follows, there are some disadvantages of the conventional procedure of excision of the submandibular gland. A longer incision is made at the lateral aspect of neck, and usually causes poorer cosmetic results. During elevating of the neck flaps, it may injure the marginal mandibular branch of the facial nerve and cause the nerve paralysis or paresthesia. A minimally invasive endoscopic resection of the submandibular gland is described for expecting to shorten incision, improve cosmetic results, and decrease the complications of the surgery. METHODS: An incision about 2 to 2.5 cm is made at about the level of hyoid bone under general anesthesia. With assistance of endoscope, the submandibular gland is divided along its capsule with harmonic scalpel. Hemoclips are used for ligation of the facial artery, the facial vein, and Wharton's duct after division and then the specimen is removed. The incision is closed by using absorbable suture in the skin after hemovac drain is inserted. RESULTS: From March 2002 to August 2002, the study group consisted of 7 patients, ranging in age from 30 years to 59 years, with a mean of 41.9 years. There were 5 males and 2 females. The duration of procedures ranged from 80 to 125 minutes with a mean duration of 100 minutes. Of the 7 patients who received excision, 2 had mixed tumor, 2 had sialolithiasis, 2 had chronic inflammation, and 1 had tuberculous sialoadenitis. The mean size of the submandibular gland was 4.4×2.9×1.5 cm. The hospitalization ranged from 2 to 3 days with a mean of 2.1 days. All excisions were successfully underwent without any complication. CONCLUSION: Comparing with the conventional procedure, there are several advantages of this minimally invasive surgery. A reduced incision length and favorable location result in improved cosmetic results. Dissection under the level of platysma muscle and above the capsule of the submandibular gland would not injure the marginal mandibular branch of the facial nerve. Because endoscopic surgery provides good illumination and magnification on the monitor, we are able to achieve clear, precise, safe dissection in a bloodless field by using harmonic scalpel. It is conceivable that minimally invasive endoscopic resection of the submandibular gland is a feasible and safe approach for patients.