The value of salivary gland scintigraphy in the diagnosis of Sjögren's syndrome remains controversial. The primary aim of this study was to estimate the diagnostic accuracy of salivary gland scintigraphy in the diagnosis of Sjögren's syndrome among 237 patients with xerostomia. We retrospectively compared eight scintigraphy parameters between 106 Sjögren patients and 131 non-Sjögren patients. Seven of the eight parameters were significantly decreased in Sjögren patients; however their diagnostic accuracy was low, with AUCs ranging from 0.58 (95% CI 0.50-0.65) to 0.63 (95% CI: 0.55-0.70). The prestimulatory oral activity index allowed discrimination between primary and secondary Sjögren's syndrome (AUC 0.73, 95% CI: 0.62-0.84) and the secretion velocity for parotid glands allowed discrimination between Sjögren patients and Burning Mouth Syndrome patients (AUC 0.71, 95% CI 0.59-0.82). The accuracy of scintigraphy parameters for the diagnosis of Sjögren's syndrome among patients with xerostomia was low, however, some functional indices appeared to assist discrimination between primary and secondary SS patients and between sub-groups of patients with different causes of xerostomia.