Abstract: Nasopharyngeal carcinoma is one of the most common malignant tumors in the southern part of China. The main etiological factors of nasopharyngeal carcinoma include genetic susceptibility, dietary factors, and Epstein-Barr virus (EBV) infection. EBV deoxyribonucleic acid (EBV DNA) can be persistently detected in the plasma of patients with nasopharyngeal carcinoma, and its levels correlate with the disease stage. After successful treatment, EBV DNA is rapidly cleared from the plasma of patients; however, significant increases in plasma EBV DNA levels are observed in patients with recurrent or metastatic diseases after treatment. Accumulating evidence suggests that EBV DNA detection is useful in the early diagnosis and screening, diagnosis of tumor recurrence or distant metastasis, prognosis, and tailored treatment of patients with nasopharyngeal carcinoma. This review summarizes the aforementioned progresses to provide a basis for future clinical and research efforts.