Twenty-seven new patients with advanced nasopharyngeal carcinoma were evaluated by marrow biopsy at diagnosis. The marrow trephines and blood clots were evaluated by morphology and immunohistochemical studies for cytokeratin and found negative in all cases. The median follow-up of this group of 27 patients was 22 months, and 7 of them had relapsed in the skeletal system. We conclude, in view of its poor sensitivity, that routine use of marrow biopsy for the staging of nasopharyngeal carcinoma is not recommended.