Adenolymphoma is the second most common benign parotid tumor after pleomorphic adenoma. Although microwave ablation (MWA) has been proved to be effective for benign breast and thyroid nodules, there are few studies on ablation of adenolymphoma of parotid gland. An 82-year-old male with adenolymphoma of bilateral parotid gland treated with ultrasound-guided MWA. After 12 months of follow-up, the volume of bilateral parotid nodules was significantly reduced without recurrence and obvious complications. In conclusion, ultrasound-guided MWA is a safe and effective method for patients with parotid adenolymphoma who cannot tolerate surgery.