Background: To investigate factors associated with overall survival in patients with newly diagnosedmetastatic nasopharyngeal carcinoma. Materials and Methods: Two hundred and two consecutive patientswith pathologically confirmed nasopharyngeal carcinoma with distant metastasis at diagnosis seen betweenDecember 2007 and May 2011 were reviewed. Patient, tumor and treatment factors were analyzed for theirsignificance regarding overall survival. Results: The median follow-up time was 22 months. At the time of thisreport, 116 patients had died. For 112 patients, cause of death was nasopharyngeal carcinoma. The 1, 2, 3, and4-year overall survival rates were 75.6%, 50.2%, 39.2%, and 28.2%, respectively. Cox regression multivariateanalysis showed that T-stage (p=0.045), N-stage (p=0.014), metastasis number (p<0.001) and radiotherapy fornasopharynx and neck (p<0.001) were significant factors for overall survival. Conclusions: Early T-stage andN-stage, solitary metastasis in a single organ were good prognostic factors for patients with newly diagnosedmetastatic nasopharyngeal carcinoma. Radiotherapy should be strongly recommended in systemic treatment.