The authors assessed the factors that influence the outcome of transoral excision of submandibular duct stones. This was a retrospective case-note review and prospective telephone survey of 125 patients, who had surgery over an eight-year period by a single surgeon. The mean period between surgery and telephone survey was 54.8 months (range between 12.8 and 113.6 months). Recurrent obstructive symptoms occurred in 14.4% of patients and tongue paraesthesia in 5.6%. Proximal and partially removed stones had a significant impact on the development of recurrent obstructive symptoms. Of note, in approximately a fifth of patients, the calculi could only be partially removed. Patients with residual stones developed obstructive symptoms with a year. No significant factors were identified related to tongue paraesthesia. There have only been a limited number of studies looking at the long-term outcome of transoral submandibular calculi, and this study is a welcome addition to the literature. It reinforces that this technique still has a role, despite the introduction of lithotripsy and sialedonscopy.