Radiotherapy is a preferred approach to nasopharyngeal carcinoma，with intensity⁃modulated ra⁃ diotherapy as a main option. However，radiotherapy targets a large area generally involving nasopharyngeal skull base and neck and thus led to carotid arterial injuries，resulting in atherosclerosis and such other adverse events as stroke. As a fallout，it will undermine the quality of life of patients and even cause disability and death. Up to date，the effect of radiotherapy on a the risk tissue of carotid artery has been generally ignored by radiation oncolo⁃ gists and the relevant studies on the effects are very few，let alone an effective model of radiation protection. This article reviews the mechanism，diagnosis and prevention of radiotherapy⁃induced carotid arterial injuries for naso⁃ pharyngeal carcinoma，aiming to increase the attention of radiation oncologists to radiotherapy⁃reduced carotid arte⁃ rial injuries and provide guidance for related research.