CT findings in 64 patients of nasopharyngeal cancer are analyzed retrospectively to evaluate the region oforigin and the route of spread. The results are as follows: 1. The most frequently involved wall is lateral wall(90%), followed by posterior wall (78%) and superior wall(58%). 2. There are invasion to parapharyngealspace(86%), retropharyngeal and prevertebral space (72%), carotid space(46%), and masticator space (18%) in thatorder. 3. Involved anatomic sites are Rosenmueller fossa(90%), torus tubarius(78%), E-tube orifice(68%), carotidsheath(46%), soft palate(50%), nasal cavity(36%), skull base(28%), prevertebral muscle(26%) and intracranialfossa(16%). 4. Direct extension to intracranial fossa is via sphenoid sunus(6/8), foramen lacerum(5/8). foramenovale(4/8), and jugular foramen(4/8) in that order. 5. Invasion to prevertebral space leads to intraspinalextension(3/13). 6. Cervical lymph node metastasis is found in internal jugular (82%), spinal accessory(56%) andretropharyngeal chain(42%) in that order. 7. After radiation therapy, most frequent site of recurrence isposterior wall (10/14) followed by lateral wall (9/14), superior wall(5/14) and cervical lymph node(6/14), but thepresence of recurrence is difficult to determine based on CT only.