BACKGROUND: Nasopharyngeal carcinoma is a rare tumor entity in Switzerland. In contrast, it is endemic in Asian and African countries. Retrospective studies have been conducted in order to identify risk factors and prognostic determinants of nasopharyngeal carcinoma. Nonetheless, these trials were mostly conducted in regions with high prevalence for the disease and little is known about the risk factors and prognosis of nasopharyngeal carcinoma for a non-endemic population in Western Europe. METHODS: This retrospective trial was conducted to identify risk factors and prognostic determinants of nasopharyngeal carcinoma for a non-endemic population in Switzerland. RESULTS: Overall survival was 91%, 77% and 58% for one, three and five years, respectively. Factors with favourable prognostic value were concomitant radiochemotherapy regimens, photon radiotherapy, and a delay between diagnosis and first therapy session of less than ten weeks, respectively. Factors with unfavourable prognostic values were age over 65 years at time of diagnosis and nasopharyngeal carcinoma of WHO Type I. CONCLUSION: Risk factors, biological behaviour and survival are well comparable between endemic and non-endemic populations for nasopharyngeal carcinoma. Nonetheless, an aggressive diagnostic procedure and sophisticated interdisciplinary therapy are indispensable in order to achieve favourable outcome. Therefore, diagnosis and therapy of nasopharyngeal carcinoma in non-endemic populations should be limited to highly specialized tertiary centres.