Objective To study the clinical characteristics, imaging findings, pathological features, treatment methods, and prognosis of nasopharyngeal carcinoma in children.Methods The clinical data of 6 children (<18 years) with nasopharyngeal carcinoma admitted to the Department of Pediatrics, Beijing Tongren Hospital from March 2021 to February 2025 were retrospectively reviewed, and outcomes were followed up.Results All 6 patients were male. Age at onset ranged from 11 to 15 years, with a median of 12.5 years. The interval from onset to diagnosis was 1-6 months. The main clinical symptoms were cervical mass (4 cases, 67%) and headache (3 cases, 50%); some patients also had nasal congestion and rhinorrhea, epistaxis, or limited mouth opening. TNM staging was stage III in 4 cases and stage IVa in 2 cases. All patients had non-keratinizing undifferentiated nasopharyngeal carcinoma on pathology. Treatments included radiotherapy, chemotherapy, surgery, targeted therapy, and immunotherapy. By July 1, 2025, after comprehensive treatment, 5 patients (83%) achieved complete remission, and 1 patient (17%) experienced recurrence and progression and died.Conclusions Comprehensive treatment based on combined radiotherapy and chemotherapy is the mainstay for childhood nasopharyngeal carcinoma, overall prognosis is favorable, and long-term follow-up is required. Molecular targeted therapy and immunotherapy are expected to improve the prognosis of advanced nasopharyngeal carcinoma and require further research for validation.