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Introduction: Sialolithiasis is a most common disease of salivary glands most commonly occurs in submandibular gland system. Simultaneous sialolithiasis in more than one salivary gland and multiple stone formations have been reported in only 5% and 3% of cases, respectively. In this article, a rare case of bilateral presence of various stones in different sizes and shapes in the submandibular glands and its duct in a 68-year-old man has been investigated.  Stones on left side were removed through an intraoral incision and on the right side; the entire salivary gland was removed with extraoral access. Conclusion: After precise diagnosis of sialolithiasis through various diagnostic modalities, treatment plan should be tailored based on existing condition and the decision was made to remove a salivary gland with extraoral access on one side and remove the stones by intraoral incision on the other side while preserving the salivary gland.