OBJECTIVE To explore the clinical features and surgical treatment methods of primary parapharyngeal space tumors.METHODS The clinical data of 38 patients with primary parapharyngeal space tumors who were treated in the Affiliated Hospital of Southwest Medical University from June 2005 to April 2023 were retrospectively analyzed,and their clinical manifestations,imaging data,surgical methods,postoperative complications,postoperative pathological types and prognosis were analyzed.RESULTS The clinical manifestations of 38 patients were mainly pharyngeal discomfort and pharyngeal distension.CT and MRI can determine the size,location,and relationship of the tumor to surrounding tissue.The surgical methods included transcervical approach in 17 cases,transoral approach in 15 cases,transcervical-transparotid approach in 4 cases,and transcervical-transmandibular approach in 2 cases.Postoperative pathology diagnosed 28 cases(73.7%)of benign tumors and 10 cases(26.3%)of malignant tumors.After the postoperative follow-up of 2 months-17 years,there was no recurrence of benign tumor patients,and patients with malignant tumors survived well after comprehensive treatment with surgery and radiotherapy and chemotherapy.CONCLUSION Most patients with primary parapharyngeal space tumors have no specific clinical symptoms,and the types of pathologies are diverse.Choosing the appropriate surgical approach to remove the tumor is key to treatment.Neurologic deficits are the most important postoperative complication.Patients with benign tumors have good long-term effects after surgery,and patients with malignant tumors have better efficacy in the combination of surgery and chemoradiotherapy.