Both TI-201 and Tc-99m MIBI uptake in nasopharyngeal carcinoma (NPC) have been reported, yet no comparative study of these two agents using SPECT images has been undertaken for NPC. This study compares the relative effectiveness of TI-201 and Tc-99m MIBI SPECT for detecting NPC. In the patients with NPC, 26 of 32 (81%) showed TI-201 tumor uptake, whereas 24 of 32 (75%) showed Tc-99m MIBI tumor uptake. This preliminary study suggests that both Tc-99m MIBI and TI-201 SPECT imaging can be helpful in detecting NPC, and that sensitivity is slightly higher in TI-201 SPECT imaging.