AJ is a 52 y.o. female with a several year history of a left submandibular duct stone. As it was only occasionally symptomatic, she was advised by her original physician to use sour candy and massage if she had swelling with eating and to hold off on surgery. As her symptoms became more frequent, she was given the option of removal of the submandibular gland or a second opinion. When we first saw her for her second opinion, the left submandibular gland was moderately enlarged and mildly tender. The stone was palpable in the left posterior floor of mouth. We felt that with trans-oral excision it might be possible to remove the stone and preserve the gland. We discussed the risks to the lingual nerve as well as the possibility that we might not be able to remove the stone through this approach and that the gland might have to be removed in that case. She was agreeable to this plan and underwent successful trans-oral removal of the stone as is demonstrated in the video. She recovered uneventfully.