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Nasopharyngeal carcinoma does not arise in an area which can be surgically resected, and treatment is therefore limited to radiotherapy. The results in early tumours are good with a 75% five-year survival, whereas in late tumours the five-year survival falls to approximately 15%. Overall, if all stages of presentation are taken into account, the five-year survival is approximately 35%. The cervical nodes, or at least the upper ones, should be included in the radiotherapy field, and if there is a palpable lymph gland at presentation this should be radiated along with the primary tumour. If it appears to respond completely to radiotherapy, it may be left and observed, but if not, or if a gland appears subsequent to the completion of radiotherapy, radical neck dissection should be performed.