Sialolithiasis is among the most common pathological conditions of the salivary glands. It is characterized by blockage of the salivary gland excretory duct or by the formation of calcareous concretions, resulting in salivary stasis and causing salivary gland swelling. Most sialoliths generally arise in the submandibular gland and duct. The size of sialoliths ranges from around 1 mm to 10 mm, with some exceeding 15 mm in dimension. Numerous conservative treatments, including milking and palliative therapy, are effective for accessible small stones. Surgical intervention is necessary when the sialoliths are large, inaccessible, or when conservative therapies fail. The present study reports a patient with large multiple submandibular gland sialoliths, with the largest measuring approximately 16 mm by 10 mm. This case highlights the importance of considering sialolithiasis in patients with submandibular swelling and the necessity of surgical intervention for large stones when conservative treatments fail. The patient's symptoms resolved postoperatively, demonstrating the effectiveness of the treatment approach.