Only 29 cases of salivary gland carcinosarcoma de novo have been described in the English-language literature. We present a new case of parotid gland carcinosarcoma de novo and discuss diagnostic and treatment modalities of this pathologic entity. Our patient underwent total parotidectomy with facial nerve preservation, chemotherapy, and radiotherapy. At 26-month follow-up, the patient presented no evidence of recurrence. One-third of the cases of salivary carcinosarcoma de novo died of the disease after a median period of 10 months. Although the number of cases is limited, the combination of radical surgical excision and radiotherapy seems currently the treatment of choice.