Nasopharyngeal angiofibroma is a benign neoplasm, but clinically considered as a malignancy because of invasiveness to surrounding structures, bleeding tendency during surgery and high recurrence rate. It occurs usually in the posterolateral wall of nasopharynx in adolescent males. Recently, we have experienced 3 cases of nasopharyngeal angiofibroma, and performed transpalatal and lateral rhinotomy approaches under hypotensive general anesthesia.