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 immunohisto-chemical 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.