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Little data about the efficacy and limitations of ultrasound-guided mechanical intraductal stone fragmentation and removal of sialoliths (Sonoguide Forceps) exist. Methods. This was a chart review of patients treated within the last 4 years at 2 tertiary care centers. Results. Sonoguide Forceps were used as a second-line treatment in 22 patients with sialolithiasis. Ten patients were free of stones and symptoms afterwards (7 of 17 submandibular, 2 of 4 parotid, 1 of 1 sublingual). Six patients were primarily treated for parotid sialolithiasis, 4 with successful stone retrieval. The reasons for failure were a lack of accessibility to the stone by the forceps (n = 9), the impossibility of grasping the stone (n = 5), and/or the concomitant grabbing of soft tissue together with the stone (n = 3). Conclusion. The efficacy of Sonoguide Forceps as both a secondary and primary treatment modality makes it an interesting, simple, and inexpensive therapeutic alternative. Relevant parameters for treatment success include the size and position of the stones. [ABSTRACT FROM AUTHOR]