During 1977 through 1986, 15 patients were evaluated and underwent surgery for nasopharyngeal angiofibroma at the Cleveland Clinic Foundation. All were males aged five to 20 years. Diagnoses were established clinically and radiographically. The most common presentations were nasal obstruction and epistaxis. Computed tomographic scans were obtained in almost all cases. In 14 patients, preoperative embolization of the tumor was performed at the time of diagnostic angiography; embolization of tumors made surgical excision easier and reduced blood loss. The most common surgical exposure used was a combination of transpalatal and transantral approaches. Follow-up of one to 10 years showed recurrence in only two patients. One had no further recurrence after subsequent surgery; the other remains asymptomatic with no further progression. The approach to diagnosis and treatment described results in cure for most patients.