Background: Submandibular gland pathology is common but rarely reported. This study was performed to evaluate demographic, pathological, and survival outcomes associated with submandibular gland extirpation. Methods: Retrospective analysis of patients treated in a single quaternary-care institution between 1989 and 2022 was performed. Results: 460 patients underwent submandibular gland extirpation with a female preponderance (n = 271, 59%) and a mean age of 51 years. Older age was associated with increased risk of malignancy (p<0.001). Submandibular calculus was the most common pathology, with gland extirpation for this indication decreasing over time (p=0.005). Pleomorphic adenoma was the most common benign tumour (n=96, 52.7% of total tumours), and adenoid cystic carcinoma was the most common malignant tumour (n= 25, 13.7% of total tumours). Conclusions: Submandibular calculus remains the most common indication for submandibular gland extirpation, although the rate is decreasing over time. Pleomorphic adenoma continues to be the most common tumour of the submandibular gland, whilst adenoid cystic carcinoma is the most common malignant tumour. The incidence of benign versus malignant tumours has remained constant over the period of this study.