The aim of this study is to report a rare case of giant sialolith located in the submandibular gland and to discuss the types of treatment with their benefits. A 42-year-old female patient presented a nodular, fibrous, sessile, painful, and mucosa-like lesion located in the right-side submandibular gland duct, which had 2.5 cm in dimensions and 10 years of evolution. Radiographic examination was requested to confirm the diagnostic hypothesis of sialolith. Surgical treatment was performed by intraoral access in the obliterated duct region, and afterward the affected gland kept in operation without relapses or postoperative complications. Numerous forms of treatment are used in the calculi removal from ductal system, and treatment may range according to size, shape, and location of the calculus. Early diagnosis is essential because of painful symptoms and discomfort. The aim of this study is to report a rare case of giant sialolith located in the submandibular gland and to discuss the types of treatment with their benefits. A 42-year-old female patient presented a nodular, fibrous, sessile, painful, and mucosa-like lesion located in the right-side submandibular gland duct, which had 2.5 cm in dimensions and 10 years of evolution. Radiographic examination was requested to confirm the diagnostic hypothesis of sialolith. Surgical treatment was performed by intraoral access in the obliterated duct region, and afterward the affected gland kept in operation without relapses or postoperative complications. Numerous forms of treatment are used in the calculi removal from ductal system, and treatment may range according to size, shape, and location of the calculus. Early diagnosis is essential because of painful symptoms and discomfort.