To detect structure and size abnormalities, magnetic resonance imaging (MRI) of the parotid gland was performed on 36 patients with sicca complaints. Twenty-four patients had primary Sjögren's syndrome (SS) without rheumatoid arthritis (RA) or connective tissue disease; 6 had secondary SS associated with RA, whereas in another 6 cases the related disease could not be classified. Characteristic gland size and structural abnormalities were identified in patients with SS and various stages could be established, compared to patients with other parotid gland disorders, as well as healthy persons. MRI provides an accurate noninvasive technique for assessment of xerostomia in patients with SS.