The major salivary glands lend themselves well to ultrasound (US) examination, owing to their location and their soft tissue characteristics. With adequate training and experience, clinicians can perform and interpret salivary gland US and frequently obviate the need for MRI or CT imaging. US features of the major inflammatory, neoplastic, and miscellaneous salivary gland disorders are described and demonstrated in this article. US-guided procedures including fine needle biopsy, sclerotherapy, and therapeutic injection have numerous applications to salivary gland pathology, and techniques are discussed. US enhances the diagnosis and management of common salivary gland diseases in the office setting.