Aim Salivary gland carcinomas (SGCs) encompass a biologically and histologically diverse group of malignancies, yet all are staged within a unified TNM staging framework. Our aim is to determine whether histological risk stratification improves prognostication sufficiently to warrant a histopathology-based staging system. Methods We performed a retrospective cohort study of 432 patients undergoing primary surgical resection for SGC between 1988 and 2025 at a tertiary head and neck oncology centre. Multivariable Cox regression was used to evaluate the independent prognostic contribution of histopathological subtype relative to established TNM factors for overall survival (OS) and disease-specific survival (DSS). Results The cohort comprised 432 patients (mean age 55.6 years; 51.6% female) with a median follow-up of 3.6 years. Primary tumour sites included the parotid gland (58.8%), submandibular gland (10.6%), and minor salivary glands (29.2%). Histopathological subtypes were stratified into low- (n=204), low-intermediate- (n=175), and high-risk (n=53) groups according to 5-year OS and DSS estimates. On univariate analysis, the high-risk group was associated with significantly worse OS (HR 3.20, p<0.001) and DSS (HR 3.95, p<0.001). However, histological risk group was not independently associated with OS (p=0.498) or DSS (p=0.998) on multivariable analysis. The strongest independent predictors of survival were nodal metastasis burden (OS: HR 1.04, 95% CI 1.016–1.060, p=0.001; DSS: HR 1.04, 95% CI 1.021–1.063, p<0.001), primary tumour size (OS: HR 1.02, 95% CI 1.004–1.035, p=0.014; DSS: HR 1.02, 95% CI 1.004–1.040, p=0.019), and male sex (OS: HR 2.58, 95% CI 1.624–4.088, p<0.001; DSS: HR 2.47, 95% CI 1.391–4.390, p=0.002). Conclusion Histopathological subtype does not independently justify a separate staging framework for SGCs. Prognosis is more robustly determined by tumour size and nodal burden, supporting the continued use of the TNM staging system.