Objective This study aimed to investigate the expression of midkine (MK) and microvessel density (MVD) in patients with salivary adenoid cystic carcinoma (SACC) and its clinical significance, as well as detect the correlation between the expression of MK and MVD in SACC.Methods Immunohistochemistry analysis (SP method) for MK and MVD were performed on 60 cases of SACC and 26 cases of normal salivary gland tissue. The expression of MK and MVD, as well as the correlation between the expression of MK and MVD in SACC were detected.Results In SACC, the MK expression rate was 70.0% (42/60), and MK was not expressed in normal tissue. Statistical significance was found between SACC and normal tissue (PPP>0.05), but correlated with tumor size, lymph node metastasis, and tumor–node–metastasis in SACC (Pr=0.560,PConclusion SACC is correlated with the expression of MK protein and the increase in MVD, which may be some of the early diagnostic markers in SACC.