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Trakya Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi AD. Edirne Nasopharyngeal carcinoma has a higher risk of distant metastases than the other head and neck malignancies. Death caused by metastatic disease is more common and the most common distant metastases region in patients with nasopharyngeal cancer is bone rather than lung. Although bone marrow invasion is especially observed in patients with bone metastases, it can also be seen with other types of metastases. In patients with metastatic disease the estimated survival time can vary between 8 to 12 months. We present a patient with bone marrow metastases resulting in pancytopenia as a case report with a brief review of the literature. Keywords : nasopharyngeal carcinoma, bone marrow metastases, case report