Aims This study aims to investigate the clinicopathological characteristics, survival outcomes and prognostic factors for primary major salivary gland malignancy (SGM) in an Australian population. Methodology A retrospective cohort study of patients ≥ 18 years with primary major SGM diagnosed between January 2001 to December 2024 at a tertiary cancer referral centre in Sydney, Australia was conducted. Clinicopathological and treatment characteristics were collected. Overall survival (OS), recurrence-free survival (RFS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method. Log-rank univariate analysis and multivariate Cox regression analysis were conducted to determine prognostic factors for OS and DFS. Results A total of 149 patients were included, with a median follow-up time of 57.5 months. Patients were mostly male (57.7%) with a median age of 59 years. Tumours were most commonly located in the parotid gland (81.2%) and were T1 (49.7%) and N0 (81.9%). The most common histological subtype was mucoepidermoid carcinoma (26.2%). The 5- and 10-year OS, RFS and DFS were 81.9% and 77.9%, 78.5% and 71.8% and 84.6% and 82.6% respectively. OS, RFS and DFS were significantly associated with histological subtype (p < 0.001). Independent prognostic factors for OS were ECOG 2/3 (HR 19.059), T3/4 (HR 6.925) and intermediate/high histological grade (HR 3.310). Independent prognostic factors for DFS were ECOG 2/3 (HR 64.267), T3/4 (HR 8.085) and intermediate/high histological grade (HR 8.065). Conclusion Survival outcomes significantly differ between histological subtypes of primary major SGM. Independent prognostic factors for OS and DFS are ECOG 2/3, T3/4 and intermediate/high histological grade.