To report our institutional outcomes of patients with non-previously treated, high-risk salivary gland malignancies treated with surgery followed by adjuvant radiation (RT) and chemoradiation (CRT). From January 1997 to December 2017, 108 patients were treated with surgery, and adjuvant RT (n = 50) or CRT (n = 58) for high-risk pathologic features: perineural involvement (PNI), lymphovascular space invasion (LVSI), positive/close (<2mm) margin, high grade, extracapsular extension (ECE), or positive lymph nodes. Adjuvant RT was delivered in 2 Gy daily fractions, and adjuvant CRT was delivered for 4-6 alternating week cycles: the most common regimen, TFHX, consisted of 5 days paclitaxel (100 mg/m2 on d1), infusional 5-fluorouracil (600 mg/m2/d × 5d), hydroxyurea (500 mg PO BID), and 1.5 Gy twice daily irradiation followed by a 9-day break without treatment. The Kaplan-Meier method was used to estimate rates of locoregional control (LRC), disease-free survival (DFS), and overall survival (OS). Regression analyses were used to identify factors associated with LRC, DFS, and OS. Multivariable Cox Regression (MVA) was performed for known confounding risk factors, and factors associated with a trend to significance (p <0.20). Chi-Square was used to compare rates of toxicities between groups. Median follow-up was 52 months (range: 3 - 226). The most common histologies included: Adenoid Cystic (n = 30), Mucoepidermoid (n = 20), and Salivary Duct Adenocarcinoma (n = 18). The most common location included the parotid (n = 73). The median RT dose was 66 Gy (range 43.2 - 74 Gy). The 5-year LRC was 88%, 5-year DFS was 57%, and 5-year OS was 78%. On MVA, LRC was not associated with any factors; DFS was associated with the size of the tumor (HR 2.0, p = 0.01), tumor location (HR 2.0, p = 0.01), and stage (HR 1.7, p = 0.02); and OS was associated with N stage (HR 2.3, p = 0.005), LVSI (HR 1.9, p = 0.012), ECE (HR 1.5, p = 0.032), and stage (HR 1.3, p = 0.05). CRT was not associated with improved LRC (HR 0.5, p = 0.34), DFS (HR 0.4, p = 0.44), or OS (HR: 0.46, p = 0.384). Since 87% of node positive patients were treated with adjuvant CRT compared to 13% with RT, therefore comparison was not possible. There was no difference in any acute or late grade 3+ toxicities, or parenteral nutrition between RT and CRT (p = 0.98, p = 0.85, and p = 0.83), respectively. There was one acute grade 5 toxicity in the RT group. To our knowledge, this is the largest single institution cohort of adjuvant CRT for high-risk salivary malignancies. Overall, adjuvant CRT doesn’t enhance outcomes compared to adjuvant RT alone. However, LRC was similar between RT and CRT groups in spite of more adverse features (nodal disease and ECE) in the CRT group. Distant metastatic disease remains a significant pattern of failure. We await large prospective evidence to determine which subsets of patients benefit from adjuvant CRT.