MMed, Otorhinolaryngology, Faculty of Health Sciences, University of the Witwatersrand / This study is a six year retrospective review of the histopathology of nasopharyngeal masses in adult patients who underwent a biopsy in theatre at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) from 1st January 2003 to 31st December 2008. Eighty one patients were included in this study. They comprised of 54 males (67%) and 27 females (33%) aged between 18 and 82 years. There was no statistical difference between the two genders in terms of their ages (p= 0.39). Fifty two patients (64%) had benign disease and 29 patients (36%) had malignant disease (ratio 1.8:1). Thirty four males (65%) and 18 females (35%) had benign disease. Twenty males and 9 females had malignant disease. There was no significant correlation between gender and malignancy (r= -0.04, p=0.75). The independent predictors of the nature of the tumour were: nasal congestion, epistaxis, hearing loss, otalgia and Human Immunodeficiency Virus (HIV) status. The statistically significant positive predictors of malignancy were the presence of nasal congestion, epistaxis and otalgia. The presence of at least one or more of these symptoms was associated with an odds ratio of 3.06 for malignant disease. (CI= 1.17-8.01). The presence of hearing loss was independently associated with benign disease (p=0.031). The HIV status was known in 41 of the 81 patients. Of the 41 patients whose HIV status was known, 25 were male and 16 were female. The HIV positive patients comprised of 19 males (76% of all males) and 9 females (56% of all females). The presence of HIV infection was independently associated with benign disease. The absence of HIV infection was in fact associated with malignant disease, with an odds ratio of 4.00 and 95% confidence intervals of 1.04 to 15.43.