<p class="abstract">Nasopharyngeal carcinoma (NPC), although rare but does occur in pediatric age group and can present with variable non-specific signs and symptoms. The objective of this report is to emphasize that, because of its rarity, it is not clinically suspected and kept in differential diagnosis of nasopharyngeal mass in children, leading to delayed diagnosis and significant therapeutic implications. We hereby, describe a case of 10 year old boy who presented with bilateral cervical lymphadenopathy and simultaneously developing proptosis of the left eye, which is one of the important rare manifestation of NPC, that creates a diagnostic challenge.</p>