Objective: The present study was designed to investigate whether acellular dermal matrix (ADM) graft could prevent Frey’s syndrome (FS) and improve aesthetic score following parotidectomy. Study Design: Retrospective study. A propensity score matched analysis. Setting:From January 2015 to December 2019, 175 patients underwent parotidectomy. Methods: We divided the patients into two groups with ADM group and Control group. We included each group of 30 patients according a propensity score matched analysis. Results: The subjective of FS was recorded in 1 patient (3%) from the ADM group and 9 patients (30%) from the Control group(P=0.015). Patients in the ADM group had a subjective aesthetic score of 6.1+1.7 compared with 5.2+1.7 in the Control group. The subjective aesthetic score for patients in the ADM group was higher than those in the Control group (P =0.040). Conclusion: The present clinical study suggests that ADM graft are effective in preventing FS and improving aesthetic score after parotidectomy.