Nasopharyngeal cancer is a low differentiated squamous cell carcinoma, and the radiation therapy is the primary choice. It's 5 year survival rate may reach 64.4%, while 10.0% cases may suffer from the local recurrence. The salvage radiation or surgery is still the main choice for recurrent cases now. However the recurrent tumor become radiation insensitive and meanwhile, morbidity and mortality become higher. The experience of open salvage surgery on the recurrent radiation insensitive tumor had been proved safely, and the related morbidity and mortality are acceptable. Recently, the endoscopic salvage surgery has been developed, some preliminary experience has been obtained and the result looks promising. In this article, the pathobiological characteristics of the postradiation local recurrent nasopharyngeal cancer, the anatomy of nasopharyngus and related skull base area, especially the petroclival region and current situation of endonasal endoscopic salvage surgery were reviewed here. Basic principle of oncological surgery that endoscopic surgery should followed and possible endoscopic surgical approaches were proposed.