Salivary adenoid cystic carcinoma is a very common malignant neoplasm in the salivary glands. One of the most important features of salivary cystic carcinoma is perineural invasion, which renders its complete removal is very difficult through clinical surgery. Consequently, tumor recurrence occurs easily after clinical surgery. Therefore, the molecular mecha-nisms of perineural invasion in salivary adenoid cystic carcinoma are necessary to explore. These mechanisms are reviewed in this paper.