A retrospective review of 381 patients with histologically confirmed nasopharyngeal carcinoma referred from all regions of Saudi Arabia to the King Faisal Specialist Hospital and Research Centre during the 10 1/2-year period (June 1975 to December 1985) demonstrated a high frequency of stage IV tumors (93%), with 17.3% having distant metastases at presentation. There was a very low incidence (2%) of keratinizing squamous cell carcinoma, considered due to the relatively young age of the population. Age analysis indicated a peak incidence among the referred cases in the 45-55 age group, with a smaller peak in the 20-24 age group for both males and females, although the younger age peaks were reduced when the patient numbers were standardized for available population census figures.