Abstract: Objective:To investigate the efficacy of re-treatment for cervical lymph node recurrence in na -sopharyngeal carcinoma patients after radiotherapy and to explore the prognostic factors. Methods: Eighty-two patients who received therapy due to cervical lymph node recurrence after definitive radiotherapy were reviewed. The relevant factors including sex, the interval between radiotherapy and recurrence, rN stage, recurrence site, treatment modalities, and treatment efficacy were analyzed. Subgroup analysis was performed to review the relevant factors including the involvement in the adjacent tissues, the number of posi-tive nodes and surgical range. Kaplan-Meier method, Log-rank test and Cox method were used for statistical analysis. Results: The 1-, 3- and 5-year local control rates were 58%,39.0%, and39.0%, respectively. The1-, 3- and 5- year overall survival rates were 82.9%,47.6%, and25.0%, respectively. The1-, 3- and 5-year over -all survival rates in the radiotherapy-based treatment group were 80.8%,37.1% and 19.1%, respectively. The 1-, 3- and 5-year overall survival rates in the surgery-based treatment group were 86.7%,66% and 34.2%, re-spectively. The efficacy of surgery-based treatment was superior to that of radiotherapy-based treatment. In the multivariate analysis, tumor recurrence site was an independent prognostic factor. Conclusion:Radical neck dissection-based treatment can achieve satisfactory efficacy for cervical lymph node recurrence after ra-diotherapy in nasopharyngeal carcinoma patients.