&NA;Necrotizing sialometaplasia is a benign self‐limited condition of salivary glands most commonly involving the palate, although extrapalatal involvement also occurs. The exact pathogenesis is unknown, but the most widely accepted theory is that necrotizing sialometaplasia develops as a result of ischemic injury to the salivary gland lobule, Necrotizing sialometaplasia has been mistaken histologically for carcinoma, particularly mucoepidermoid and squamous carcinomas. Misdiagnosis can be avoided by appreciating the characteristic maintenance of lobular architecture despite necrosis of salivary gland tissue and the presence of squamous metaplasia within residual ducts and acini. The recognition of necrotizing sialometaplasia as a potential simulator of carcinoma is essential in sparing patients inappropriate and excessive therapy.