Saliva is of major importance in taste, speech, swallowing, and protection against dental caries. Neck dissection surgery and/or radiotherapy may impair the function of the submandibular glands. Over the years, there has been a trend toward more conservative approaches to neck dissection. Metastasis to the submandibular gland itself is extremely rare and if removal of the lymph nodes of sublevel IB is imperative, it seems feasible to preserve the submandibular gland, unless it is involved by direct tumor extension of the primary tumor or the adjacent metastatic lymph nodes. Clinical studies to validate this concept are needed.