Objective To explore the distribution rule of metastatic lymph node in nasopharyngeal carcinoma (NPC). Methods 148 cases with NPC confirmed by pathology or clinical methods in our hospital from Jan. 2012 to Aug. 2013 underwent MRI scanning with plain and contrast enhanced sequences. The distribution of lymph node was divided according to RTOG guidelines proposed in 2008.The differences rates of lymph nodes metastases were analyzed. The distribution law of metastatic lymph node of different primary sites and the skip metastasis were also analyzed. Results 148 cases with NPC included the primary left wall of the nasopharyngeal (n=12), the right wall (n=6),superior/ posterior wall (n=9), the extensive regain (n=112), and 9 without obvious lesion . 143 out of 148 patients(96.6%) had lymph node involvement, with 124 cases involved the RN node, 117cases involved the neck node, and with 26 cases (17.6%) in RN alone, 19(12.8%) in neck node alone, and 98(66.2%) both necks and RN node. The cases of lymph node metastasis in Ia, Ib, IIa, IIb, III, IV, Va, Vb, RN were 0, 7, 94, 105, 62, 25, 11,14,202,7 respectively. 2 cases(1.3%) were found distant metastasis,one was the liver, the other was the bones. Skip metastasis was found in 2 cases (1.3%). Conclusions The incidence of lymph node metastasis is high in nasopharyngeal carcinoma, the RN and IIb lymph nodes were most likely to be involved.There was significant difference in RN metastasis between the primary tumor being located merely on the superior/posterior wall and lateral wall. The lesions limited or involved the superior/ posterior had a higher probability in metastasizing. The primary lesion limited at the unilateral wall can metastase to the offside or bilateral lymph nodes. Distribution rule of metastatic lymph node was corresponding to the rule of lymphatic drainage, Skip metastasis rate was very low.