High-grade mucoepidermoid carcinomas (MEC) present as rapidly growing mass which may be painful. They are mostly solid with an infiltrative growth pattern (as seen in this case). In high-grade lesions, squamous cells, intermediate cells and clear cells are the dominant cell population. Mucinous cells are scanty. This 62 y/o male patient presented with a complaint of swelling in the left submandibular region for 2 months. A fine needle aspirate was suggestive of squamous cell carcinoma. Conservative excision with modified radical neck dissection was done. The specimen showed a solid gray-white tumor with gelatinous surface measuring 8.5 cm in greatest dimension. The tumor appeared to invade the skeletal muscle underneath. Uninvolved salivary gland can be seen on the lower right of the specimen. Microscopically, it was a high-grade mucoepidermoid carcinoma. Case courtesy of: Dr. Sanjay D. Deshmukh, Dept. of Pathology, Smt. Kashibai Navale Medical College, Pune, India.