We report a peculiar case of radiocontrast induced anaphylactoid shock following an intravenous pyelography, which was announced by an hyperacute bilateral parotid enlargement as the sole prodrome. From a review of the literature, two clinical presentation of iodide-induced sialadenitis are individualized according to their pathogenesis. In patients with normally functioning kidneys, the occurrence of a sialadenitis after a short delay (5 minutes to 24 hours) evokes an anaphylactoid mechanism. In patients with renal function impairment, the role played by extrarenal excretory pathways of iodinated compounds and especially the salivary glands, results in a delayed onset (1 to 5 days) of the sialadenitis due to an effect of toxicity.