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Rationale: Parotid gland sarcoidosis is a well-recognized, but uncommon disease entity. Parotidectomy is most commonly performed to establish the diagnosis and most patients are treated with corticosteroids. Patient concerns: A young female patient presented with right parotid enlargement and developed symptoms of facial nerve palsy during diagnostic investigation. Diagnoses: A fine-needle aspiration cytology showed granulomatous inflammation. The diagnosis of sarcoidosis was eventually established based on the demonstration of the characteristic lambda and panda signs by a Gallium-67 scintigraphy. Interventions: No specific pharmacologic therapy was initiated. Outcomes: The patient's symptoms regressed completely over a period of 3 months. Additionally, she remains asymptomatic 2 years later. Lessons: This case underlines the importance of not initiating corticosteroids in all patients with parotid gland sarcoidosis and suggests that parotidectomy can be avoided in the presence of characteristic for sarcoidosis imaging findings.