Objective The aim of this study was to analyze the clinical characters, diagnosis and treatment of primary neo- plasms in the parapharyngeal regions.Methods Atotal of 115 cases of primary neoplasms in the parapharyngeal regionswere includ- ed in this study.Results Disorders of swallowing, breath or speakingwere the common symptoms of neoplasms in parapharyngeal re- gions. The majority of neoplasms parapharyngeal regionswere benign. 46 caseswere from the deep lobe of the parotid, and 42 cases were neurogenic. CT orMRI provides useful information such as their sizes, shapes and extents. The relationship between the tumor and vessel was shown using super-selective angiography. All the tumors were resected completely by extra-oral approach through the posteroinferior incision of the mandible. The follow-upwas carried out from1 to 10 years, and the data indicated that 2 patients died, 18 cases were lost, and others had no recurrence.Conclusion CT and/or MRI are essentially useful for diagnosis and presurgical planning. Super-selective angiography can be used if the lesions involved carotid artery. Posteroinferior incision of the mandible is a simple, effective and safe approach for excision of neoplasms parapharyngeal regions.