Fine needle aspiration is a well-established modality for the preoperative evaluation of salivary gland lesions. No standardized classification system was available for cytopathology reporting of salivary gland lesions until recently. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is an evidence-based standardized reporting system for salivary gland lesions which was proposed under the sponsorship of the American system of Cytopathology and the International Academy of Cytology in the year 2015. MSRSGC consists of six diagnostic categories, offering the risk of malignancy and clinical management recommendations for each category. The main goal of this system is to improve communication between cytopathologists and clinicians and to enhance reproducibility in the management salivary gland lesions. Here in, we review the essential features, diagnostic criteria and clinical management of each category in MSRSGC along with emphasis on ancillary studies.