BACKGROUND: Surgery for tumors in the mid-cheek area are challenging. Endoscopic-assisted dissection of benign mid-cheek tumors is gradually being reported. This study evaluated the indications, advantages and disadvantages of endoscopically assisted mid-cheek benign tumor resection using a single preauricular or transoral incision and compared it with the conventional approach. METHODS: Fifty-four patients with benign mid-cheek tumors could be divided into three groups: a conventional (20 patients) parotidectomy access surgery group, another two endoscope-assisted tumor dissections groups through a single preauricular incision (17 patients) or transoral incision (17 patients). Their surgical approaches were introduced, and the tumor long-axis length, incision length, operative time, estimated intraoperative bleeding, postoperative drainage amount and time, aesthetic satisfaction, perioperative complications, and follow-up were recorded and analyzed. RESULTS: The tumor long-axis lengths were comparable between the groups, and all surgical procedures were completed as planned. The endoscopic procedure group improved the incision size, intraoperative blood loss, drainage, perioperative complications, and cosmetic satisfaction. Meanwhile, aesthetic pleasure is highest with the transoral incision. No tumor recurrence was found during the 1-54-month of follow-up. CONCLUSION: Endoscopic-assisted preauricular or transoral incision for dissecting mid-cheek benign tumors is more aesthetic and minimally invasive than conventional surgical approaches with available results, reducing complications, narrowing the surgical incision, and obtaining satisfactory aesthetic results.