Purpose <p>This study aimed to comprehensively analyze salivary gland secretory carcinoma (SGSC) using a large population-based cohort to determine temporal patterns, identify independent survival predictors, and evaluate treatment effectiveness for optimizing clinical management.</p> Methods <p>We conducted a retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) database. A total of 212 patients diagnosed with SGSC between 2011 and 2021 were included. We analyzed clinicopathological features, incidence trends, and prognostic factors using Kaplan-Meier analysis and Cox proportional hazards models.</p> Results <p>With a median follow-up duration of 36.5 months, the overall 5-year and 10-year survival rates were 89.93% and 86.53%, respectively. The incidence of SGSC has shown a significant upward trend, increasing from an average of 6.3 cases per year in 2011–2013 to 29.3 cases per year in 2019–2021. This increase was predominantly driven by early-stage (I/II) tumors (75.9%), with the parotid gland being the most common primary site. Multivariable analysis identified age &gt; 55 years and AJCC Stage IV disease as independent poor prognostic factors. Surgical intervention, including local tumor excision and glandectomy, was significantly associated with improved overall survival. Notably, patients who received a combination of surgery and radiotherapy had better outcomes compared to those who received either treatment alone.</p> Conclusion <p>This large-scale study with extended follow-up clarifies the rising incidence and early-stage predominance of SGSC. Age, TNM stage, and surgical treatment were identified as key prognostic factors.</p>