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No sponsorships or competing interests have been disclosed for this article. Objective. To describe the different surgical techniques for nasopharyngeal endoscopic resection (NER) and to support the efficacy of the endoscopic endonasal approach in the management of selected primary and locally recurrent naso-pharyngeal tumors (NPTs). Study Design. Case series with chart review. Setting. Patients affected by NPTs who underwent NER from 1997 to 2011 at two Italian referral centers. Subjects and Methods. NER was tailored to the NPT exten-sion and classified as follows: type 1 NER, resection of the posterior nasopharyngeal wall; type 2 NER, resection super-iorly extended to the sphenoid; type 3 NER, trans-pterygoid approach to the postero-lateral nasopharynx with removal of pterygoid plates and Eustachian tube, under control of parapharyngeal-petrous-cavernous segments of the internal carotid artery. Results. Thirty-six consecutive patients with primary (9 cases) or locally recurrent (27 cases) NPTs were enrolled. The lesions were staged as follows: stage I, 16 (44.4%); stage II, 3 (8.4%); stage III, 15 (41.6%); and stage IVA, 2 (5.6%)