Infiltrating angiolipomas are tumors consisting of adipose tissue marked by vascular proliferation and are nonencapsulated or partially encapsulated. These tumors are very rare in the head and neck. This is the first case report of infiltrating angiolipoma arising from the nasopharynx causing the Eustachian tube dysfunction. A 29-year-old female presented with a history of earfullness and nasal obstruction. A sessile mass was found at the left superior-lateral wall of the nasopharynx. The mass was excised by a transnasal endoscopic approach. The tumor was adhered to the cavernous sinus containing an aberrant internal carotid artery that was located in an abnormally low portion in the cavernous sinus. The patient is currently free of growth of remained tumor 4 years after endoscopic surgery.