NPC is common in Hong Kong. In the broad sense, NPC includes keratinizing squamous cell carcinomas, nonkeratinizing carcinomas, undifferentiated carcinomas, and adenocarcinomas. It is mainly the undifferentiated carcinoma that is prevalent in the Hong Kong region. We report our histologic experiences with nasopharyngeal malignancies, emphasizing the undifferentiated carcinomas that make up 82.4% of all nasopharyngeal malignancies in the Prince of Wales Hospital, Hong Kong. Important features of histopathologic diagnosis of NPC are discussed in the context of the literature.