Nasopharyngeal carcinoma (NPC) is one of the common cancers in China. According to mass surveys, the incidence of NPC in some areas of Guangdong is 39.84/100,000. Due to its high contrast resolution CT has the ability to show not only superficial abnormality but also deep infiltration of the fasciae and muscles of the parapharyngeal region. Computed tomography scanning was performed on more than 1000 patients with NPC in the Tumour Hospital in the 2 years from 1984 to 1986. The role of CT scanning in NPC can be summarised as: (1) detection of primary lesions not accessible to pharyngoscopy; (2) determination of the extent of disease; (3) clinical staging; (4) radiotherapy planning; (5) follow up evaluation; (6) the differentiation of recurrence and radiation damage to the brain; and (7) the demonstration of distant metastasis. In contrast to the concept of jugular chain metastasis via the postero-lateral pharyngeal lymph nodes, our material has demonstrated that the lesion most probably spreads to the carotid sheath area directly from the pharyngeal lesion. The tendency of submucosal spread of NPC is emphasised.