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Background:    Sialolithiasis is a common disease of the major salivary glands, but it is rarely seen in the sublingual gland. Patients commonly experience pain and/or swelling, but dysphagia is presented in extended lesions.
    Case Report:    In this report we present a 67-year-old woman who had 268 sialoliths in the sublingual gland, forming a huge mass and causing dysphagia. The diameter of the largest sialolith was approximately 4 mm. The diagnosis of sialolithiasis was confirmed pathologically.
    Conclusions:    Multiple sublingual gland sialoliths are considered rare; they may cause symptoms like dysphagia and speech difficulty. To our knowledge our patient had more sialoliths in a sublingual gland than any previous reports in the literature.