Of 381 patients with nasopharyngeal malignant tumors, 113 were found to have neurological complications. In 84% of patients the nasopharyngeal mass presented with general symptoms such as head-face pain, otologic manifestations, glandular neck swelling, and nasal or pharyngeal discomfort. Sixteen percent presented with neurological symptoms. The time from the onset of general symptoms of the disease to the appearance of neurological complications ranged from one month to seven years and in the majority was less than three years. In two thirds of the patients the neurological picture began with either diplopia or sensory disturbance in the face. Neurological examination revealed cranial nerve damage in almost all cases. The abducens nerve was involved in 68% of patients, the trigeminal in 47%, and the glossopharyngeal-vagus in 38%. Many combinations of cranial nerve lesions were found; those including the fifth and sixth nerves were the most common. Follow-up studies revealed that of the 113 patients, 9 were alive, 85 were dead, and 19 were lost to follow-up. Survival time ranged from a few months to 13 years. The absolute five-year survival rate was 24%.