Obstructive salivary gland disease, commonly due to stones or ductal stenosis, often causes gland swelling, pain, and infection. While traditional treatments include conservative measures and surgical excision, sialendoscopy has emerged as a minimally invasive, gland-preserving approach. This technique allows for diagnostic visualization and concurrent treatment of intraductal pathology such as stones, stenosis, and inflammation. Office-based sialendoscopy offers additional benefits, including patient convenience, avoidance of general anesthesia, and reduced costs. Success relies on careful patient selection, technical proficiency, and appropriate equipment. Despite challenges like equipment costs and reimbursement barriers, sialendoscopy has demonstrated high efficacy, safety, and patient satisfaction, transforming salivary gland management.