Nasopharyngeal carcinomais one of the leading malignancies with obscure etiology. Circulating tumor cellshave been showed to intimately correlate with characteristics in different kinds of cancer. But links between circulating tumor cells andnasopharyngeal carcinoma were still lacking. Therefore, we exploredcirculating tumor cells' distribution innasopharyngeal carcinoma and their possible associations withnasopharyngeal carcinoma. Firstly, we found that the positive ratio ofcirculating tumor cells is extremely high in four stages ofnasopharyngeal carcinoma. Meanwhile, positive ratios of mesenchymalcirculating tumor cells were higher in early stages ofnasopharyngeal carcinoma. Apart from epithelialcirculating tumor cells, total, hybrid and mesenchymalcirculating tumor cells were correlated withnasopharyngeal carcinoma clinical stage. Our results showed that hybrid and mesenchymalcirculating tumor cells were associated withnasopharyngeal carcinoma metastasis (both distant and lymph node) and smoking. Meanwhile, hybridcirculating tumor cells expressed the highest Epstein-Barr virus proteins and deoxyribonucleic acid in three types ofcirculating tumor cells. Moreover, we found that Epstein-Barr virusproteins viral-caspid antigen-immunoglobulin A (VCA/IgA) and early antigen-immunoglobulin A (EA/IgA), but not Epstein-Barr virus-deoxyribonucleic acid, had a closed association withnasopharyngeal carcinoma metastasis. However,Epstein-Barr virus hallmarks failed to associate with othernasopharyngeal carcinoma characteristics. Furthermore, we confirmed that matrix metalloproteinase 9existed incirculating tumor cells and expressed most in mesenchymalcirculating tumor cells. In addition, matrix metalloproteinase 9-expressed extent in hybridcirculating tumor cells is somewhat different from epithelial and mesenchymalcirculating tumor cells in matrix metalloproteinase 9-positivecirculating tumor cells. Nevertheless, matrix metalloproteinase 9 had no relationship with othernasopharyngeal carcinoma characteristics. Finally, our results showed thatcirculating tumor cells were decreased in patients after therapies. Taken together,circulating tumor cells were tightly correlated withnasopharyngeal carcinoma characteristics. In addition, Epstein-Barr virus was associated withnasopharyngeal carcinoma metastasis. Of note, decreasedcirculating tumor cells indicated a favorable curative effect in nasopharyngeal carcinoma patients.