bcl‐2 protein and Ki‐67 (MIB‐1) were studied in 32 acinic cell carcinomas (ACCs), all with a minimum of 5 years' clinical follow‐up. Tumour apoptosis was evaluated by TdT dUTP nick end labelling (TUNEL) and by morphological criteria. Five patients died of their disease. Patients with stage I tumours had significantly better survival compared with other stages (P<0·05). Patients with MIB‐1‐negative tumours had significantly better survival than patients with MIB‐1‐positive tumours (P=0·05). This study confirms a previous report that MIB‐1 is an independent prognostic factor for survival in patients with ACC. Stage I tumours had high expression of bcl‐2 protein, but there was no difference when compared with other stages. TUNEL positivity was most prevalent in stage I tumours, compared with stages II, III, and IV (P<0·05), probably indicating more apoptosis. This could imply a capacity of stage I tumours (‘early tumours’) for early selection of tumour cells for elimination by apoptosis. There was no significant difference between expression of bcl‐2 and TUNEL, between these parameters and clinical outcome, or between any parameter and morphological subclassification. We conclude that MIB‐1 has prognostic value in ACC. Clinical staging, bcl‐2, and TUNEL are also potentially useful as prognostic markers. © 1997 John Wiley & Sons, Ltd.