Introduction Nasopharyngeal carcinoma (NPC) is malignancy of squamous cells on nasopharyngeal epithelial layer and the most common otorhinolaryngology malignancy found in Indonesia. Etiology of NPC is multifactorial including, food, environment, genetics, and Epstein-Barr virus infection. The study aimed to determine the highest risk factors on the incidence of nasopharyngeal carcinoma in Otorhinolaringology-Head and Neck Surgery Department dr. Hasan Sadikin General Hospital Bandung. Method The study design was descriptive retrospective from medical record of NPC patients at Otorhinolaringology-Head and Neck Surgery Department, dr. Hasan Sadikin General Hospital Bandung in 2010-2015. Result There were 462 nasopharyngeal carcinoma patients in this research (265 men and 161 women) with three most common risk factors history of smoking (50.7%), mosquito coils use (43.2%), and consumption of salty fish (39.7%). Conclusion Smoking, mosquito coils, and consumption of salty fish affect the incidence of nasopharyngeal carcinoma.