BACKGROUND: Metastatic involvement of pericardium producing cardiac tamponade is rare. When occurs it is mainly from the lung, breast and the neoplasms of the lymphoreticular system. Hematogenous spread of parotid adenocarcinoma to heart is extremely rare and only two cases have been reported in literature so far. CASE PRESENTATION: We report an unusual case of a patient with adenocarcinoma of the parotid gland, which presented with cardiac tamponade and was treated urgently with pericardial drainage and intrapericardial injection of cisplatin. CONCLUSIONS: Our case demonstrates the possibility of metastatic pericardial involvement and cardiac tamponade in patients with parotid adenocarcinoma. The patient was successfully treated with pericardial drainage and intrapericardial injection of chemotherapeutic agent to control recurrent pericardial effusion.