Abstract: Nasopharyngeal carcinoma (NPC) exhibits a remarkable geographical distribution, and its etiology has garnered significant attention, encompassing genetic, Epstein-Barr virus (EBV), and environmental factors. With the deepening of research, the epidemiological characteristics of NPC etiology have been gradually refined. This article focuses on the findings from one case-control study, the NPC genes, environment and Epstein Barr virus (NPCGEE) project, conducted in Guangdong and Guangxi provinces, to summarize the latest advancements in the epidemiology of NPC etiology. Genetic factors play a crucial role in the etiology of NPC. Early EBV infection may have a causal relationship with the development of NPC, and the high-risk subtypes of EBV may interact with host genes to jointly promote NPC progression. The NPCGEE project provides new insights into the epidemiology of NPC, particularly in terms of environmental etiology: a diminished role of Chinese-style saltpreserved fish, modest positive associations with passive smoking and indoor air pollution, unclear associations with occupational exposure to formaldehyde and inhaled dust, and potential effects of oral health and the oral microbiome on NPC. The etiological characteristics of NPC evolve with more rigorous research designs and environmental changes. To gain a deeper understanding of the interplay between NPC genetic factors, EBV and environment, large-scale pooled studies must accumulate sufficient cases with detailed exposure data.