Abstract: Objective: To assess the accuracy of histopathologic diagnosis of ultrasound-guided biopsy for salivary gland lesions. Methods: Ultrasound-guided biopsy was performed in 101 patients for salivary gland lesions. Results: All diagnoses were confirmed.In 68 patients undergoing surgery,95.6%（65/68）of lesions were correctly depicted as benign（sensitivity=100%,47/47;specificity=94%,47/50） or malignant（sensitivity=85.7%,18/21;specificity=100%,18/18） on the basis of ultrasound-guided biopsy.Furthermore,91.2%（62/68） were accurately diagnosed,including 95.7%（45/47） benign lesions（specificity = 90%,45/50） and 81%（17/21） malignant tumors（specificity=100%,17/17）.33 lesions were diagnosed as benign non-tumor lesions on the basis of ultrasound-guided biopsy;and these lesions became smaller or did not change after related treatment confirmed by 1-45 months（mean 19±12.8 months） follow-up.Three lesions were misdiagnosed without immunohistochemistry examination.Two lymphomas were misdiagnosed as hyperplasia of lymphatic tissue and one adenoid cystic carcinoma were misdiagnosed as pleomorphic adenoma.The results of logistic regression analysis showed that accuracy of biopsy diagnosis was correlated with pathologic property and quantity of tissue. Conclusion: Ultrasound-guided biopsy is reliable in distinguishing benign and malignant salivary gland lesions.A specific histopathologic diagnosis is often possible.Immunohistochemistry examination is needed for the accurate diagnosis of hyperplasia of lymphatic tissue.