Abstract: Objective:To analyze the prognostic factors through retrospective study on the surgical treatment of 23pa-tients with pulmonary metastases in nasopharyngeal carcinoma (NPC). Methods:Surgery was performed in all cases. Uni -variate analyses were respectively conducted for the effect of related factors on the overall survival rate, these factors were the disease-free interval, the size of tumors, number of metastases, mode of surgery, adjunctive therapy, and clinical stag -ing. The multivariate analysis of Cox proportional hazards regression model was also performed for these factors. Results: Complete follow-up data of the patients was recorded in our study. The1, 2, 3 and 5-year survival rates in the patients were 95.7%,65.2%,56.5% and 21.7%, respectively, with a median survival time of 50.8 months. The length of the disease-free interval (DFI) correlated with the postoperative survival rate in the patients ( P=0.026 ). There was no statistical significance in comparison between the differences in the number of metastases, tumor size, mode of surgery (OPEN or VATS), wedge resection or lobotomy of the lung, with or without systematic mediastinal lymph node dissection (SND), with or without radio -therapy and/or chemotherapy after surgical resection, or in the differences between the effect of postoperative adjuvant chemo-radiotherapy and overall survival rate, in the patients (P>0.05). The patients with distant metastasis after surgery ac-counted for52.2% of the total, with a very low survival rate (P=0.014 ). The analytic result of Cox regression was OR= 5.512 (P=0.029 ). Conclusion : Surgery is a therapeutic tool in treating the pulmonary metastases of NPC. The length of DFI is one of the indicators affecting the prognosis of the patients after surgical treatment on the metastasis. The major reason for the failure of surgery is distant metastasis recurrence. There are no statistically significant differences in comparison of the overall survival and the related factors, such as the number of pulmonary metastases, tumor size, mode of operation by OPEN or VATS, wedge resection or lobotomy, the necessity of SND, and radiotherapy and / or chemotherapy after surgery.