Abstract: Nasopharyngeal carcinoma(NPC) is an epithelial malignancy that has a remarkable geographic distribution and is highly prevalent in Southern China.NPC patients with negative cervical lymph nodes(stage-N0 NPC) account for 5% to 35% of the total NPC cases.The prophylactic irradiation volume and dose of regional nodes for patients with node-negative NPC remain controversial. This review summarizes the pattern of node metastasis in NPC, the use of imaging techniques, such as computed tomography and MRI scan in diagnosing the node metastases, and the prophylactic elective irradiation of cervical lymph nodes in node-negative patients.