Objectives: This study aims to evaluate the pattern of nodal metastasis to level V in parotid cancer and to examine the clinical value of level V neck dissection (LVND). Study Design: Retrospective study. Methods: LVND was performed in 10.6% and 28.2% of patients with clinical N0 (cN0) and cN+ neck disease, respectively. The prevalence of pathological positive nodal metastasis was 0% (cN0) and 81.8% (cN+). In patients with cN0 neck, the rate of recurrence in level V was 6%. Conclusion: in our patient cohort, LVND was necessary in patients with cN+ neck because there was a high likelihood for pathologically positive nodal metastasis. In patients with cN0 neck, the rate of recurrence in level V was low enough not to warrant a routine inclusion of LVND.