Painless enlargement of the parotid glands was studied in 21 patients in whom this condition was associated with the clinical signs of hepatic cirrhosis and a long history of alcoholism. In no case was any other salivary gland involved. Sialography, parotid biopsy, and measurement of the resting rate of salivary secretion were performed in each case. This differential diagnosis is valuable after specific parotid diseases have been ruled out in directing attention to a certain group of conditions including latent diabetes, liver cirrhosis and precirrhotic changes. Opinions differ as to the cause of the asymptomatic parotid enlargement but nutritional deficiency states and endocrine disorders, or both, are possible factors. Histological changes of the parotid vary little in the different underlying diseases and are not definitely characteristic of them.