We report a rare case of first branchial cleft cyst arising from the nasopharynx.A 47-year old woman with a six-month-history of right ear stuffy and hearing loss was studied.Electronic nasopharyngeal examination revealed a mass in the nasopharynx of this case.The tumor was removed endoscopically with endonasal approach.Postoperative pathological examination indicated that it was branchial cleft cyst.