A population-based case-control study was conducted in Shanghai, China, to investigate the association between dietary factors and risk of nasopharyngeal carcinoma (NPC). The study included 935 NPC patients aged 15 to 74 years and 1,032 community controls. Exposures to salted fish and other protein-containing preserved food were associated with increased risk of NPC. Individuals who ate salted fish at least once a week had an 80% increase in risk of NPC relative to those who ate salted fish less than once a month (p = 0.07). Compared with those in the lowest quartile of protein-containing preserved foods, subjects in the highest quartile of intake experienced a statistically significant 78% increase in risk of NPC [odds ratio (OR) = 1.78, 95% confidence interval (CI) = 1.37-2.31], with a dose-dependent relationship (p for linear trend < 0.001 ). A similar association between intake of preserved vegetables and NPC risk was observed (OR = 1.39, p for linear trend = 0.003). In contrast, high intake of oranges/tangerines was associated with a statistically significant reduction in risk of NPC (OR = 0.55, p for linear trend < 0.001). When we examined the joint effect of preserved food and oranges/tangerines on risk of NPC, subjects in the highest tertile of preserved food and the lowest tertile of orange/ tangerine intake had a 3-fold increase in risk (95% CI = 2.08-4.91) compared with those in the lowest tertile of preserved food and the highest tertile of orange/tangerine intake.