The standard of care for patients with recurrent and metastatic nasopharyngeal carcinoma remains unclear. There is an urgent need to identify effective and low-toxicity treatment methods for such patients. The integration of current evidence to form an optimal treatment modality for recurrent and/or metastatic nasopharyngeal is worth exploring. In recent years, several outstanding clinical trials have emerged for the comprehensive treatment of recurrent and/or metastatic nasopharyngeal carcinoma . New evidence has been added for the local treatment of patients with metastasis. Endoscopic surgery, radiomics, and other technologies help achieve precise local treatment. Novel immunotherapeutic drugs have been approved for the treatment of patients with metastasis in China. The combination of immunotherapy, chemotherapy, and targeted therapy is promising and requires confirmation. Future studies will continue to focus on individualization and precision medicine.