Fine needle aspiration cytology (FNAC) is a very useful tool in the preoperative diagnosis of lesions of the salivary gland. Surgical therapy of high-grade malignancies (salivary duct carcinoma, mucoepidermoid carcinoma, squamous cellcarcinoma, carcinoma ex pleomorphic adenoma, small cell carcinoma, and sebaceous carcinoma) is different from that of benign lesions or low-grade malignancies. Therefore, the recognition of high-grade malignancies is important in salivary gland FNAC. Although recognition of high-grade malignancies of the salivary gland by FNAC is not difficult, precise classification of these malignancies is often impossible. Additionally, because of its rarity, FNAC of spindle cells and mesenchymal lesions of the salivary glands is a tool that is not familiar to many cytopathologists. The characteristic cytomorphologic features of these lesions are reviewed here with a discussion of specific diagnostic problems.