Carotid artery stenosis caused by radiation injury is a late complication after radiotherapy for patients with malignant tumors of the head and neck. A case of nasopharyngeal carcinoma with multiple stenosis and dissection of cervical vessels more than 20 years after radiotherapy is reported. At the same time, combined with the current domestic and foreign literature reports on this type of disease, analyze its clinical characteristics and related research progress in treatment methods for literature review.