Nasopharyngeal cancer has a distinct geographic and ethnic distribution, occurring at high rates among ethnic Chinese from southeastern China and at much lower rates among Caucasians. While infection with EBV is believed necessary for development of the cancer, other factors, both genetic and exogenous, may be important. To investigate genetic, dietary, occupational, and behavioral factors related to the etiology of nasopharyngeal cancer, a case-control study was conducted in Taiwan. To date, our results suggest an association between risk and specific variants of the enzyme CYP2E1, HLA, smoking, and dietary micronutrients. Other dietary and occupational factors are also under investigation, including consumption of nitrates, nitrites, and nitrosamines, and occupational exposure to formaldehyde, solvents, wood dusts, and nitrosamines. A large-scale linkage study is now under way in Taiwan to enable an assessment of genetic and environmental determinants of this cancer.