Objective: To investigate the clinical presentation and misdiagnostic causes of 507 patients with nasopharyngeal carcinoma. Methods: The analysis was performed in 507 cases of the nasopharyngeal carcinoma treated from January 1996 to the end of 1999. Results: The clinical presentation of patients with nasopharyngeal carcinoma includes epistaxis

nasal obstruction

ear pain

hearing loss

headache

cervical lymph node involvement

cranial nerve involvement and horner’s syndrome. At the time of initial diagnosis

the rate of misdiagnosis was 86.98% for all cases. The duration before getting pathologic document was longer in patient with mild symptoms such as epistaxis

nasal obstruction and/or ear pain than that with headache

cranial involvement and/or cervical lymph node involvement. Conclusion: Our results demonstrate that it is an important procedure for patients with symptoms linking to nasopharyngeal carcinoma to receive careful examination for the ear

nasopharynx and nose.