OBJECTIVES To evaluate the diagnostic value of narrow band imaging (NBI) for detection of nasopharyngeal carcinoma (NPC).STUDY DESIGN Prospective study.Setting: Tertiary medical center SUBJECTS AND METHODS Between December 2009 and June 2010, a total of 1854 patients were examined by means of electronic nasopharyngolaryngoscope equipped with conventional white light (WL) and NBI system.The sensitivity, specificity, and positive/negative predictive values for detecting nasopharyngeal carcinoma were calculated and compared.RESULTS Of these patients, sixty two cases (3.34%) were pathologically confirmed as NPC.The sensitivity, specificity, positive predictive value, and negative predictive value for detecting NPC significantly increased from 90.3%, 75.4%, 11.3% and 99.6% with WL up to 100%, 99.2%, 81.6% and 100% with NBI, respectively.CONCLUSION Our findings suggested that NBI endoscopy might serve as an ideal tool in detection of NPC.