Abstract: Objective To explore the prognostic factors of nasopharyngeal carcinoma (NPC) patients. Methods Clinical data were collected from patients who were diagnosed with NPC between 2010 and 2015 from SEER database using SEER*Stat software. Univariate and multivariate Cox regression analyses were used to explore the clinical factors affecting the prognosis of NPC patients. Finally, a nomogram was established to predict the 1-year, the 3- and 5-year cancer-specific survival (CSS) rate. The discriminatory and predictive capacities of the nomogram were assessed by concordance index (C-index), calibration plots, area under the curve (AUC) and time-dependent receiver operating characteristic (ROC) curve. The clinical use of nomogram was estimated by decision curve analysis (DCA). Results A cohort of 367 patients with NPC was analyzed. Multivariate analysis showed that race, marriage, AJCC T, AJCC N, radiation, liver metastasis, and age at diagnosis were independently associated with CSS. These factors were applied for the establishment of the nomogram. According to ROC curve, the 1-, 3-, and 5- year overall survival rates (AUC) were greater than 0.65, and internal and external calibration plots showed excellent agreement between nomogram prediction and observed outcomes. DCA analysis showed that the nomogram had better clinical benefits than radiotherapy. Conclusions The nomogram can accurately predict the prognosis of NPC patients, with good clinical application value.