Aim: This study aims to review the nasopharyngeal carcinoma patients with distant metastases. Materials and methods: This is an analytic case-control study. The populations of this study are patients with distant metastases of nasopharyngeal carcinoma as the case group and patients without distant metastases as the control group. The data, such as general characteristics and risk factors, were taken from medical records of two cancer referral hospitals in West Java between 2016 and 2020 with a consecutive sampling method. Categorical data will be analyzed with Chi-square or exact Fisher's test. While numerical data will be analyzed using unpaired t test. Results: Forty-two patients showed distant metastases based on biopsy and imaging studies. Most of both case and control groups were male (73.8 and 81.0%), aged more than 45 years old (69.0 and 64.3%). The most frequently found risk factors in the case group were salted fish (85.7%) and instant noodle (83.3%) consumption. The age of salted fish consumption started, the usage of mosquito coils, and family history are significantly associated with distant metastases of nasopharyngeal carcinoma. Conclusion: The initiation age of salted fish consumption, usage of mosquito coils, and family history are significantly associated with distant metastases of nasopharyngeal carcinoma. Special attention should be given to these populations to decrease the incidence of distant metastases and improve the outcome. Clinical significance: The knowledge of general characteristics may increase the awareness of distant metastases and decrease the mortality rate due to metastases.