The early symptom of nasopharyngeal carcinoma is not obvious, it is easy to be misdiagnosed as endodontic disease with the first symptom of headache in the department of stomatology. The authors report a case of nasopharyngeal carcinoma misdiagnosed as endodontic disease and discuss the causes of misdiagnosis, the differential diagnosis and preventive measures, which helps strengthen the understanding of this disease and reduce the occurrence of misdiagnosis.