Our review included 988 cases of carcinoma ex pleomorphic adenoma (CXPA) in the Surveillance, Epidemiology, and End Results database from 1973-2011 and includes the parotid, submandibular gland, sublingual gland, oral cavity and pharynx. The most common location for CXPA was the parotid gland with a decrease in the reported overall incidence rate noted since 1973. A racial predilection was noted (Black greater than White) and a higher incidence was noted in males. Grade III CXPA had the worst 5-and 10-year disease specific survival. The overall average incidence rate of CXPA for 1973-2011 was 0.68 persons per million. The overall 5-and 10-year survival for CXPA was 63.2% and 44.6%, respectively.