Objective To analyze the clinical treatment modalities and clinical prognosis of patients diagnosed with primary nasopharyngeal adenoid cystic carcinoma (NACC).Methods The medical records of 46 patients with NACC between March 1971 and November 2015 were retrospectively analyzed.Among them,22 patients were male and 24 female.The median age of all patients was 47 years (range:23-74 years).Among them,34 patients received radiotherapy alone including 25 patients treated with conventional radiotherapy and 9 receiving intensity-modulated radiation therapy (IMRT).Five patients underwent salvage surgery for the residual tumors after radiotherapy.Twelve patients were treated with a comprehensive treatment modality (surgery combined with radiotherapy).Results The median follow-up time was 66.0 months (range:11.0-270.6 months).The 5-and 10-year overall survival,locoregional failure-free survival,and distant metastasis failure-free survival rates were 70％ and 40％,64％ and 47％,70％ and 62％,respectively.In the radiotherapy alone group,12(35％) cases obtained complete response,13 had partial response and 9 remained stable after radiotherapy.The 5-year overall survival and locoregional failure-free survival rates in the radiotherapy alone and combined therapy groups were 69％ and 74％,63％ and 66％,respectively (all P＞ 0.05).Conclusion The course of NACC is relatively slow.Radiotherapy is recommended for patients with high sensitivity towards radiotherapy.Salvage surgery is feasible for those who are insensitive to radiotherapy or with residual tumor after radiotherapy.