Introduction: Lesions mimicking malignancies in the nasopharynx are frequently seen in adult patients. These include inflammatory, metaplastic, and cystic lesions. We aimed to draw attention to rare tumor-like lesions that can be confused with malignancies and cause diagnostic difficulties clinically and radiologically. Methods: A total of 538 patients who underwent nasopharyngeal biopsy in our center between January 2010 and June 2020 were evaluated. Patient information was obtained from patient files and evaluated retrospectively. Results: A total of 19 of the 538 patients had tumor-like lesions that were included in the study. Granulomatous inflammation was present in seven cases, oncocytic metaplasia in four cases, benign cyst in five cases, fungal infection in two cases, and immunoglobulin G4–related disease in one case. Conclusions: The nasopharynx is a region where various lesions can be seen. Some lesions form tumor-mimicking mass effect, cause increased thickness, and lead to increased metabolic activity in positron emission tomography–computed tomography that create the illusion of a malignant tumor and histopathologic verification is crucial. We aimed to present these rare tumor-like lesions that should be kept in mind in the differential diagnosis.