목적: To describe the differences in the treatment and outcomes of submandibular stones in different locations. 방법:Between March 2017 and December 2024, we analyzed 279 sialoliths in 225 patients with submandibular gland (SMG) stones. We evaluated the SMG sialoliths and divided each case based upon the sialolith location and surgical approach. Data of all patients were retrospectively collected for sialoliths localization, shape, size and surgical approachs. Outcomes regarding sialolith localization, surgical approach were compared. P value was calculated using one-way ANOVA test, chi- square test, or Fisher’s exact test between groups. 결과:A total of 225 patients underwent treatments; sialendoscopy only (initially planned and succeeded) (n=33), intraoperative conversion from sialendoscopy to intraoral approach (n =43), intraoral approach only (n=148), and SMG resection (n=1). A total of 279 sialoliths are located in the distal duct (n=107), proximal (n=39), or hilum (n=132) location. Among surgical approach groups, sialendoscopy success group show lower stone diameter as 3.6±0.9 mm, compared to other groups (conversion group: 4.9±2.5, intraoral approach only 7.6±4.8 mm). The proportion of smooth-surfaced sialoliths was significantly higher in sialendoscopy group compared to the conversion groups and intraoral approach only group. For the distal duct, the sialendoscopy success rate was higher for smooth-surfaced stones compared to spiculated stones; however, no difference was observed in the proximal or hilar locations. The cut-off stone size for sialendoscopy success was 4.19 mm. Factors influencing recurrence include old age and a history of previous sialolithiasis. 결론:Our results demonstrate the efficacy of sialendoscopy-assisted sialolith removal for SMG sialoliths smaller than 4.19 mm in long-axis diameter. While spiculated margins did not affect removal success in the hilar and proximal ducts, they adversely impacted outcomes in the distal duct.