The incidence of ischemic stroke in patients with or without radiotherapy (RT), radiotherapy / chemotherapy (CT) is higher than the normal population in nasopharynx carsinoma. Carotid stenosis and cerebrovascular diseases due to RT and KT can cause severe disability and death. As a late complication of RT, late onset diffuse carotid artery atherosclerosis and occlusion may occur over the years, the mechanism is considered to be multifactorial. In this article, ischemic stroke occurrence due to direct tumor invasion of nasopharyngeal carcinoma and intracranial internal carotid artery (ICA) stenosis after RT, have been reported. A 43 year old male patient presented to our clinic with the complaint of left arm weakness. In right ICA area pieced diffusion limitation were seen, antiplatelet therapy with a diagnosis of ischemic stroke were begun. It was learned that he had been diagnosed with nasopharyngeal carcinoma 2 years ago and at the first diagnosis RT had been given and subsequently continued with chemotherapy. Tumoral invasion around right ICA and stenosis were seen in MRI. Because of cavernous sinus invasion one year ago, 3.4.6.cranial nerve palsy were determined in his right eye. Right arm 3/5 paresis were meliorated to +4/5 paresis during hospitalization. In this paper, ‘ischemic stroke due to nasopharyngeal carsinoma can occur because of RT and direct intracranial ICA tumor invasion’ wanted to be emphasized.