We present two cases of adenoid cystic carcinoma at the Royal Hobart Hospital. Both patients were aged 32 and 66 years respectively and presented following referrals to the Head & Neck clinic. The 66 year old had a short two to three month history of swelling and pain in the right floor of mouth, before being diagnosed after initial investigation with adenoid cystic carcinoma of the right sublingual gland. Initial staging and subsequent CT guided biopsy of pulmonary nodules confirmed metastatic disease. He underwent definitive surgical resection of his right floor of mouth, right level 1 to 3 neck dissection and flap reconstruction. The 32 year old had a long ten year history of a small painless lump on left palate, with recent discomfort at the left temporomandibular joint. Initial biopsy was inconclusive and wider excision confirmed the diagnosis of adenoid cystic carcinoma with both peri-neural and intra-neural invasion and positive surgical margins. Staging confirms local disease but nil evidence of metastatic disease. Both patients are for ongoing surveillance with the younger patient declining further surgical intervention at this time.