Parotid gland surgery includes different procedures designed to treat benign and malignant lesions of the parotid gland, typically performed under general anesthesia. Intraoperative nerve monitoring allows monitoring the integrity of the nervous system, which, by normal anatomy, puts the motor/sensory integrity of certain nerves at risk, preventing neurological complications. In addition to an adequate surgical technique, the anesthetic approach must also be appropriate. The anesthesiologist must be familiar with the different intraoperative nerve monitoring techniques and understand the impact that the anesthetic approach can have on the procedure. Teamwork between the anesthesiologist and the surgeon is paramount.