Radiotherapy is commonly used to reduce the risk of recurrence of malignant parotid gland tumours. We report our experience with radiotherapy for parotid malignancies at the Royal Marsden Hospital. We retrospectively reviewed the case notes of 90 patients with malignant parotid tumours who were treated with megavoltage irradiation between 1995 and 2005 at the Royal Marsden Hospital, and obtained details about age, sex, pathology, type of operation, type of radiotherapy, and outcome. Outcome data included date of recurrence, whether local or metastatic, date of death, and cause of death. Outcome for patients who had definitive operations compared with those who did not were analysed separately. Forty-three patients (54%) had superficial parotidectomy, 26 (33%) had total parotidectomy, and 11 (13%) had fine needle aspiration (FNA). Adenocarcinoma, squamous cell carcinoma (SCC), and mucoepidermoid carcinoma were the most prevalent histologically confirmed tumours. Radiation was given most often by the lateral wedged pair field technique. Five-year locoregional control was better for patients who had definitive operations and postoperative radiotherapy than for those who did not (82% compared with 21%), disease-free survival was 58% compared with 29%, and overall survival was 68% compared with 0%, respectively.