Nasopharyngeal carcinoma (NPC) is a major public health problem in Hong Kong with an annual incidence of 15.4/100,000. About 180 new cases are seen and treated each year in our department. All patients are subjected to a uniform staging protocol, and the aggressive radiotherapy (RT) technique used has resulted in the highest loco-regional control rate in the region. In patients with loco-regionally advanced disease on presentation, the rate of subsequent distant metastasis is high. In these patients the use of a multi-modality approach has been extensively investigated in our center. The publications of these trials have made significant impact on standard treatment approach for these patients. Patients with the most loco-regionally advanced disease on presentation have an improved outcome with concurrent chemotherapy-radiotherapy compared with radiotherapy alone. For patients with loco-regionally recurrent and/or distant metastatic disease, encouraging results of several Phase II chemotherapy trials and translational studies have led to the initiation by the group of a multicenter prospective trial using chemotherapy and specific targeting agent against Epidermal Growth Factor Receptor (EGFR). The Epstein-Barr virus (EBV) is consistently associated with NPC. In collaboration with the Johns Hopkins Oncology Center and the University of Birmingham CRC Institute of Cancer Studies, with funding from the National Cancer Institute (USA) and the Cancer Research Campaign (UK), we have initiated trials of novel immunotherapeutic approaches in the treatment of patients with NPC. The first of these has been completed and preliminary results have been reported.