Intense uptake of m-[131I] iodobenzylguanidine (I-131 MIBG ) has been observed in the salivary glands of patients undergoing scintigraphy for the location of suspected pheochromocytomas. This uptake of radioactivity was not due to free I-131 derived from the I-131 MIBG but rather to uptake of I-131 MIBG by sympathetic neuronal elements in the salivary glands. In keeping with this, administration of tricyclic antidepressants reversibly blocked salivary uptake of I-131 MIBG . Furthermore, I-131 MIBG uptake was markedly diminished by the ipsilateral salivary glands in a patient with Horner's syndrome, and was bilaterally diminished in a patient with severe idiopathic sympathetic autonomic neuropathy. The salivary gland uptake of I-131 MIBG may provide a means for the study of sympathetic innervation of these organs, and thus for the study of generalized disorders of autonomic innervation.