<p>Parotidectomy is traditionally performed under general anesthesia. However, scattered reports have described the use of local or regional anaesthesia in selected patients, particularly those with significant comorbidities or in settings where access to general anaesthesia is restricted by resource or infrastructure constraints. No systematic synthesis of the available evidence on this topic currently exists. This scoping review followed Joanna Briggs Institute and PRISMA-ScR guidelines. A systematic search of five databases from 1968 to December 2025 identified studies reporting parotidectomy under local or regional anesthesia. Data on anesthetic techniques, patient characteristics, outcomes, and complications were extracted and synthesized qualitatively. Sixteen studies encompassing 235 patients were included. Most were retrospective case series. Local/regional anesthesia was primarily used in patients with benign tumors and high anesthetic risk. Reported outcomes included low rates of conversion to general anesthesia (0.4%) and permanent facial nerve injury (1%). Parotidectomy under local or regional anesthesia appears feasible and safe in selected cases. Further prospective and comparative studies are needed to confirm efficacy and guide standardization.</p>