<h3>Purpose/Objective(s)</h3> Parotid tumors in the pediatric and young adult (PYA) population are a rare entity with a paucity of data available regarding treatment outcomes and toxicities. Most reports are long-term results of small series of patients treated with a wide variety of historical techniques. We aim to report our experience with modern highly-conformal radiation techniques for this unique population. <h3>Materials/Methods</h3> IRB approved retrospective review of 9 PYA patients (defined as age 0-25 at diagnosis) with parotid tumors treated with radiation therapy (RT) at one institution. Tumor characteristics, treatment modality, disease status, dosimetry, and acute and late toxicities were collected from the medical record. <h3>Results</h3> Nine PYA patients (5 female, 4 male) with received RT for parotid gland tumors from 2015-2022. The median age at diagnosis was 22 years (range 12-24). Median follow up was 34.4 months from RT completion. No patient had metastasis at diagnosis. Tumor histologies were: 4 mucoepidermoid carcinomas (n=1 sclerosing subtype); 1 acinic cell carcinoma, 1 adenocarcinoma, 1 NUT midline carcinoma, and 2 benign recurrent pleomorphic adenomas. All underwent total parotidectomy before RT. Three had disease involving only the deep lobe, 3 had only superficial involvement, and 3 had multifocal disease. Six patients underwent unilateral neck dissection at the time of parotidectomy; only 1 patient with a malignant tumor did not. Three patients had lymph node positive disease. The median time from surgery to RT was 6.7 weeks (range 4.7-10.7). Seven patients were treated using intensity modulated proton RT (IMPT), 1 started with intensity modulated RT (IMRT) for the first 20 of 30 fractions (fx) and transitioned to IMPT, and 1 was treated with IMRT alone. The most common dose and fractionation was 60 Gy in fx (n=7). One patient was treated using 66 Gy in 33 fx and n=1 with recurrent unresected gross disease received 69.96 Gy in 33 fx. The most common acute toxicities were grade 1-2 xerostomia, RT dermatitis, mucositis, alopecia, dysgeusia, and fatigue. No patient required a feeding tube or hospitalization during RT. One patient with NUT midline carcinoma histology received concurrent chemotherapy with cisplatin and etoposide. The most common late toxicities were grade 1-2 trismus, RT fibrosis, alopecia, lymphedema, and hearing loss. Two patients required thyroid supplementation after completing treatment – both received IMRT. There were no reported instances of osteoradionecrosis or extensive dental caries. All patients were alive at the time of data collection. There were no locoregional recurrences, and one patient (NUT midline carcinoma) developed distant metastatic disease. <h3>Conclusion</h3> Highly conformal proton/IMRT following surgical resection provides excellent local control with an acceptable toxicity profile for PYA patients with parotid gland tumors.