Management of recurrent nasopharyngeal carcinoma is a challenge to head and neck surgeons. Traditional methods of nasopharyngectomy for the treatment of recurrent nasopharyngeal carcinoma carry considerable complications. This report describes the technique of potassium-titanyl-phosphate (KTP) laser nasopharyngectomy under nasopharyngoscopic guidance. This technique allows access to the nasopharynx without damaging structures in the facial region. It results in minimal blood loss, and requires no nasal packing. We report the use of this technique to treat 6 patients with recurrent nasopharyngeal carcinoma. All patients were able to resume their oral diet 8 hours after recovery from general anesthesia, and were discharged within 2 days. Our results suggest that this technique is useful for excising locally recurring nasopharyngeal carcinomas. Prospective trial of this technique with long-term follow-up is necessary to determine its effectiveness and safety.