The local control rate of nasopharyngeal carcinoma in the period of accurate intensity modulated radiotherapy is very high. Only 10% to 20% of the patients will have local or lymph node recurrence after the first radiotherapy. Locally recurrent nasopharyngeal carcinoma is still potentially curable. However, the retreatment of locally recurrent nasopharyngeal carcinoma needs to be optimized. According to the latest clinical research evidence, we explore the recurrence pattern of nasopharyngeal carcinoma and the choice of treatment of locally recurrent nasopharyngeal carcinoma.