Over the last few years the use of ultrasonography (US) in the study of salivary glands is greatly increased due to its several advantages and undoubted diagnostic potential in detecting even minimal soft tissue changes in a wide range of pathological processes. Nowadays, there is general agreement in considering US as a useful complement to other imaging techniques, such as magnetic resonance, in providing an accurate assessment of the salivary glands especially in the study of tumour pathologies. US is also useful for the evaluation of inflammatory process affecting salivary glands (e.g. Sjögren's syndrome) where its accuracy and feasibility make it a reliable method. The useful combination of the US grey-scale and the colour/power Doppler technique provides more valuable details regarding the presence and degree of soft tissues blood perfusion and may be valuable in narrowing the differential diagnosis. This review provides an overview of the main US findings observed in a wide range of pathological processes that can affect salivary glands.